National Provider Identifier
Shane Corbin Anderson, MD
Shane Corbin Anderson, MD is listed in the NPPES registry with a primary specialty of Sports Medicine (Orthopaedic Surgery) Physician in Lewiston, NY and a listed phone number of (530) 012-7015.
Profile Overview
- NPI
- 1952863946
- Provider Type
- Individual
- Primary Specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- Enumeration Date
- April 01, 2019
- Last Updated
- July 17, 2025
Practice Location
- 5300 Military RD
- Lewiston, NY 14092-1903
Phone: (530) 012-7015
Specialties
- Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X)
- Orthopaedic Surgery Physician (207X00000X)
Full Record
- NPI
- 1952863946
- Entity Type
- Individual
- Last Name
- Anderson
- First Name
- Shane
- Middle Name
- Corbin
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 5300 Military RD
- Mailing City
- Lewiston
- Mailing State
- NY
- Mailing ZIP Code
- 14092-1903
- Mailing Country
- US
- Mailing Phone
- (314) 514-3500
- Mailing Fax
- (716) 297-1701
- Practice Street Address
- 5300 Military RD
- Practice City
- Lewiston
- Practice State
- NY
- Practice ZIP Code
- 14092-1903
- Practice Country
- US
- Practice Phone
- (530) 012-7015
- Enumeration Date
- April 01, 2019
- Last Updated
- July 17, 2025
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- July 17, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X), Orthopaedic Surgery Physician (207X00000X)
- Other Identifiers
- 200144492 (MO)