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Individual
SHAWN D. TRASK
Active
Individual
SHAWN D. TRASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
20926
TN
208000000X
Pediatrics Physician
Primary
33419
AL
208000000X
Pediatrics Physician
TP873
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180920
—
AL
05
—
3056158
—
TN
05
—
65927394 GROUP
—
KY
05
—
7100095850 INDIVIDUA
—
KY
Enumeration date
09/22/2006
Last updated
05/04/2020
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