Michael E Shahan, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

14482 Issued in WV

Practice address

608 New Hope Rd Ste 7
Princeton, WV 24740-2287

Phone

(304) 487-1076

Fax

(304) 425-9499

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lively Pediatrics, PLLC

  • Pediatrics Physician
  • Princeton, WV
  • NPI 1063006047
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1720087612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247401559",
            "telephone_number": "304-487-1076",
            "fax_number": "304-425-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 NEW HOPE RD STE 7",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402287",
            "telephone_number": "304-487-1076",
            "fax_number": "304-425-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHAN",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WV",
            "license": "14482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0123913000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miriam Seay
• Jill Renae Sells, PRSS-MH
• Leslie Sexton, BSW
• Myrtle Charlene Sexton
• Shawna Sexton
• Brittany Shanklin
• McKenzie Sharitz
• Amy Marie Sharp, PTA
• Samantha Kay Shaw
• Donna Ruth Shay, MS CCC SLP

• Diagnostic Radiology Physician in Princeton, WV
• Providers in Princeton, WV by specialty
• Diagnostic Radiology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.