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Individual

KENNETH ALLAN SHANE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3381 MONTROSE AVENUE, AKRON, OH 44333-2411
(330) 666-6801
(330) 666-6801
Mailing address
3381 MONTROSE AVENUE, AKRON, OH 44333-2411
(330) 666-6801
(330) 666-6801

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002062
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000132340
ANTHEM BLUE CROSS BLUE SH
OH
01
000000165933
ANTHEM BLUE CROSS BLUE SHIELD
KY
01
0007763250
AETNA
TX
05
0561682
OH
01
341466072
UNITED AMERICAN INSURANCE
01
480003668
RAILROAD MEDICARE
GA
01
SH0520022
STANDARD LIFE AND ACCIDEN
Enumeration date
02/27/2007
Last updated
07/04/2011
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