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NPI Code Detail

MEDICARE: STEPHEN CRAIG SHY II D.O.

MEDICARE: STEPHEN CRAIG SHY II D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician34.008017OH
2208D00000XGeneral Practice Physician03066KY
3208D00000XGeneral Practice Physician51270SC
4208D00000XGeneral Practice Physician1947WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598737991
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN CRAIG SHY II D.O.
Provider Business Mailing Address
First Line : PO BOX 390
Second Line :
City : HUNTINGTON
State : WV
Zip : 25708-0390
Country : US
Telephone Number : 304-429-1088
Fax Number : 304-429-3109
Provider Business Practice Location Address
First Line : 601 20TH ST
Second Line :
City : HUNTINGTON
State : WV
Zip : 25703-1512
Country : US
Telephone Number : 304-781-0076
Fax Number : 304-525-7402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 10/20/2022

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