Individual
CHRISTOPHER T SHELBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4950 NORTON HEALTHCARE BLVD, SUITE 205, LOUISVILLE, KY 40241-2845
(502) 583-1697
(502) 583-2120
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000690096
ANTHEM- NNIKY
KY
01
—
122151
SIHO- NNIKY
KY
01
—
50032045
PASSPORT- NNIKY
KY
05
—
7100155340
—
KY
01
—
P00948789
RAILROAD MEDICARE
KY
Enumeration date
08/20/2007
Last updated
12/10/2018
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