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General NPI Number Information
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NPI Number | 1033206560
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Entity Type | Organization
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Legal Business Name | RICHMOND UROLOGY, INC.
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 1013 CENTER DR STE. 5
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City | RICHMOND
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State | KY
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Zip | 40475-3841
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Country | US
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Telephone | 859-626-0042
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Fax | 859-626-0047
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Provider Business Mailing Address
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Address Line | 1013 CENTER DR STE. 5
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City | RICHMOND
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State | KY
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Zip | 40475-3841
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Country | US
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Telephone | 859-626-0042
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Fax | 859-626-0047
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID J SHAFRAN
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Credential | MD
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Telephone | 859-626-0042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 31835
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License Number State | KY
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