Individual
SHOBHA HARIDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
285 SOUTHSIDE MALL RD, SOUTH WILLIAMSON, KY 41503-3905
(606) 430-2226
(606) 237-7530
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 430-2230
(606) 237-2526
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
19739
WV
208000000X
Pediatrics Physician
Primary
39430
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64943178
—
KY
05
—
6700091000
—
WV
Enumeration date
05/16/2006
Last updated
10/06/2022
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