Individual
MICHAEL W SHADOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
106 E WAYNE ST, GLASGOW, KY 42141-2636
(270) 651-9129
(270) 651-4916
Mailing address
PO BOX 1537, GLASGOW, KY 42142-1537
(270) 651-9129
(270) 651-4916
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21473
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057712
ANTHEM
KY
05
—
64214737
—
KY
Enumeration date
03/23/2006
Last updated
09/15/2016
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