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Individual

DR. STUART HENRY SHAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
6614 LOGAN DR, EVANSVILLE, IN 47715-8236
(812) 477-6700
(812) 477-2152
Mailing address
2199 LEDGEWOOD DR, NEWBURGH, IN 47630-8057
(812) 858-1997
(812) 477-2152

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002521 B
IN

Other

Enumeration date
03/22/2006
Last updated
11/05/2007
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