Individual
DR. CHARLES PHILIP SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1054 CENTER DR STE 2, RICHMOND, KY 40475-3851
(859) 625-5242
(859) 625-5279
Mailing address
800 ROSE ST, LEXINGTON, KY 40536-7001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03139
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100076180
—
KY
Enumeration date
10/24/2008
Last updated
09/14/2020
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