Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01041143A | IN |
N | 207X00000X | Orthopaedic Surgeon | 036054951 | IL |
N | 207X00000X | Orthopaedic Surgeon | 31910 | KY |
Y | 207X00000X | Orthopaedic Surgeon | 350559319S | OH |
NPI | 1023013471 |
---|---|
Provider Name | Dr. George Theodore Shybut |
First Address | Cincinnati, OH 45245-1318 |
Second Address | Cincinnati, OH 45245-1318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 23/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000382638 | ANTHEM (01) | OH |
0785011 | (05) | OH |
0903535 | UNITED HEALTHCARE (01) | OH |
3284491 | CIGNA (01) | OH |
B73825 | (02) | |
P00321556 | MEDICARE RAILROAD (01) | OH |