CHARLES B SHANE MD PSC; NPI #1215067780

Contact Information

CHARLES B SHANE MD PSC

4001 KRESGE WAY
SUITE 315
LOUISVILLE, KY 40207-4640

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

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NPI Profile & details for CHARLES B SHANE MD PSC

NPI Number 1215067780

LBN Legal business name CHARLES B SHANE MD PSC

Authorized official CHARLES SHANE - (OWNER PHYSICIAN)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/06/2007

Last updated 02/24/2009 - About 17 years ago

Identifiers

KY	License #	18903
KY	Medicaid	64189038
KY	Other	000000068700	ANTHEM

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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CHARLES B SHANE MD PSC

Contact Information

Specialty

Gynecology

NPI Profile & details for CHARLES B SHANE MD PSC

Reviews for CHARLES B SHANE MD PSC