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Contact Information

CHARLES B SHANE MD PSC
4001 KRESGE WAY
SUITE 315
LOUISVILLE, KY40207-4640
 Phone: 502-895-7445
 Fax: 502-895-6638
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for CHARLES B SHANE MD PSC · (Female)

NPI # 1215067780
Status Active
Credentials
Entity Individual
Enumeration date 03/06/2007
Last updated 02/24/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • KY License # 18903
  • KY Medicaid 64189038
  • KY Other 000000068700 ANTHEM
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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