Individual
SHAWN MICHAEL ACINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FACS
Contact information
Practice address
30 MEDPARK SQUARE DR, STE 1, SOMERSET, KY 42503-1709
(606) 677-8360
(606) 677-8399
Mailing address
30 MEDPARK SQUARE DR, SUITE 1, SOMERSET, KY 42503-1709
(606) 677-8360
(606) 677-8399
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01074322A
IN
208800000X
Urology Physician
22723
IL
208800000X
Urology Physician
Primary
49477
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001036081
ANTHEM BCBS KY
KY
01
—
12063358
CAQH
KY
01
—
1942319850
HUMANA
KY
01
—
50115464
PASSPORT
KY
05
—
7100436510
—
KY
Enumeration date
08/30/2006
Last updated
04/18/2017
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