Shane, Charles B

Shane, Charles B is an sole proprietor health care provider with primary practice located at 205 Sycamore Hills Ct , Louisville KY 40245-5095. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Shane, Charles B can be contacted via phone (502) 243-8330.

Contact Information

Primary practice address
205 Sycamore Hills Ct Louisville KY 40245-5095
Phone: (502) 243-8330
Fax: (502) 243-8330
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 18903 Kentucky

Profile Details

NPI number 1386617298
LBN Legal business name Shane, Charles B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 10th, 2006
Last updated Jun 18th, 2009 - about 15 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 1386617298 NPPES
Kentucky Other 000000068700 ANTHEM
Kentucky MEDICAID 64189038 ANTHEM

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