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Individual
DR. TREVECCA KERRY SHAW
Active
Individual
DR. TREVECCA KERRY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00338
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000614278
ANTHEM
—
05
—
2919864
—
OH
Enumeration date
06/25/2008
Last updated
03/17/2021
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