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Individual

KENNETH ALLAN SHANE

Active
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Individual

KENNETH ALLAN SHANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002062
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000132340
ANTHEM BLUE CROSS BLUE SH
OH
01
—
000000165933
ANTHEM BLUE CROSS BLUE SHIELD
KY
01
—
0007763250
AETNA
TX
05
—
0561682
—
OH
01
—
341466072
UNITED AMERICAN INSURANCE
—
01
—
480003668
RAILROAD MEDICARE
GA
01
—
SH0520022
STANDARD LIFE AND ACCIDEN
—
Enumeration date
02/27/2007
Last updated
07/04/2011
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