Larue, Shane Joseph

Larue, Shane Joseph is an individual health care provider with primary practice located at 100 Medical Dr , Hannibal MO 63401-6877. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology. Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology is his primary health care specialty. Larue, Shane Joseph can be contacted via phone (573) 231-3167.

Contact Information

Primary practice address
100 Medical Dr Hannibal MO 63401-6877
Phone: (573) 231-3167
Fax: (573) 221-1659
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 2009013305 Missouri
Allopathic & Osteopathic Physicians / Advanced Heart Failure and Transplant Cardiology 207RA0001X 2009013305 Missouri

Profile Details

NPI number 1811955180
LBN Legal business name Larue, Shane Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Mar 3rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811955180 NPPES
Missouri MEDICAID 1811955180
Missouri MEDICAID ENROLLED

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