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Individual

DR. CHRISTOPHER TRAVIS SHADY

Active
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Individual

DR. CHRISTOPHER TRAVIS SHADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34.013445
OH
207R00000X
Internal Medicine Physician
5101021834
MI
207R00000X
Internal Medicine Physician
Primary
DO52105
SC

Other

Enumeration date
06/25/2015
Last updated
08/17/2020
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