Individual
ROBERT W. SHAW III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 BARRET AVE, LOUISVILLE, KY 40204-1743
(502) 540-7200
(502) 540-7207
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20242
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050956
ANTHEM
KY
01
—
000023028F
HUMANA
KY
01
—
008909
SIHO
KY
05
—
100360800
—
IN
01
—
1054774
PASSPORT
KY
01
—
10806119
CAQH
KY
01
—
110139027
RAILROAD MEDICARE
KY
01
—
2433724000
PASSPORT ADVANTAGE
KY
01
—
2538067
CIGNA
KY
05
—
64202427
—
KY
Enumeration date
04/18/2006
Last updated
07/14/2016
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