Shaw, Gregory Edward

Shaw, Gregory Edward is an sole proprietor health care provider with primary practice located at 100 Mallard Creek Rd Ste 395 , Louisville KY 40207-5167. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Shaw, Gregory Edward can be contacted via phone (502) 895-9421.

Contact Information

Primary practice address
100 Mallard Creek Rd Ste 395 Louisville KY 40207-5167
Phone: (502) 895-9421
Fax: (502) 899-5762
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 50503 Kentucky

Profile Details

NPI number 1588081566
LBN Legal business name Shaw, Gregory Edward
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 27th, 2014
Last updated Sep 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588081566 NPPES
Kentucky MEDICAID 7100488410
Kentucky Other K246121
Kentucky MEDICAID 300011149

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