Individual
KEBEDE W SHIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 PLEASANT VALLEY RD STE 202, OWENSBORO, KY 42303
(270) 417-7500
(270) 417-7509
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 691-8070
(270) 691-8026
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
51581
KY
207RI0011X
Interventional Cardiology Physician
Primary
51581
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100547610
—
KY
Enumeration date
07/12/2010
Last updated
05/14/2019
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