Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 0059942 | CO |
N | 207SG0201X | Clinical Genetics (M.D.) | 35-074339 | OH |
NPI | 1285650150 |
---|---|
Provider Name | Shawn E Mccandless |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 30/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000224392 | UNISON (01) | OH |
000000293277 | ANTHEM (01) | OH |
000000529592 | ANTHEM (01) | OH |
1023344460001 | (05) | PA |
1285650150 | (05) | MI |
1285650150 | BCMH (01) | OH |
2411509 | (05) | OH |
363819 | WELLCARE (01) | OH |
7113093 | AETNA (01) | OH |
745994 | BUCKEYE (01) | OH |
H01675 | (02) | OH |