Individual
DR. KEVIN J SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8099 CORNELL RD, CINCINNATI, OH 45249-2231
(513) 793-3933
(513) 793-8299
Mailing address
8099 CORNELL RD, CINCINNATI, OH 45249-2231
(513) 793-3933
(513) 793-8299
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
35-07-4581-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2531602
—
OH
01
—
P00139146
MEDICARE RAILROAD
OH
Enumeration date
07/31/2006
Last updated
04/01/2009
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