Individual
DR. SHAWN TRAVIS GREATHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1911 CHESTER BLVD, RICHMOND, IN 47374-1212
(765) 962-4872
(765) 935-8913
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 962-4872
(765) 935-8913
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01073741A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000951920
ANTHEM
—
05
—
201241270
—
IN
Enumeration date
05/16/2008
Last updated
05/14/2021
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