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General NPI Number Information
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NPI Number | 1730593187
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Entity Type | Individual
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Provider Name | KATELYN MARIE SHOE MD
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Gender | Female
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Dates
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Enumeration Date | 06/13/2014
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1701 CORNWALL RD STE 201
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City | LEBANON
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State | PA
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Zip | 17042-7480
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Country | US
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Telephone | 717-675-1780
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Fax |
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Provider Business Mailing Address
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Address Line | 311 N 4TH ST STE 1
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City | OAKLAND
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State | MD
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Zip | 21550-1371
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Country | US
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Telephone | 301-334-7855
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Fax | 301-334-7828
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 27751
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License Number State | MD
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