Individual
MR. SAMUEL CHASE SHOPTAW I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-C
Contact information
Practice address
3900 KRESGE WAY STE 51, LOUISVILLE, KY 40207-4683
(502) 899-3623
Mailing address
409 CAPTAIN FRANK RD, NEW ALBANY, IN 47150-5047
(502) 435-9542
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3018689
KY
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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