Individual
ISAAC SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-5689
Mailing address
231 ALBERT SABIN WAY, MSB 1654, CINCINNATI, OH 45267-0769
(513) 558-8114
(513) 558-5791
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
52410
KY
207P00000X
Emergency Medicine Physician
57.026084
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100576330
—
KY
01
—
K299710
MEDICARE
KY
Enumeration date
04/01/2015
Last updated
07/29/2019
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