NPI 1508825456

Shane a Maxwell, DO

Practitioner Interventional Pain Medicine Physician Meridian, ID

Practice location

Address: 3551 E Overland Rd, Meridian, ID 83642-6757
Phone: (208) 884-1333
Fax: (208) 489-5188
Mailing address: PO Box 1128, Boise, ID 83701-1128

Registered specialties

Interventional Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0014X Licence O0385 (ID)

Other Pain Medicine providers in Idaho →

Registry record

NPI: 1508825456
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Mar 2006
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.