Provider Demographics
NPI:1598729360
Name:SHEE, GEORGE T (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:T
Last Name:SHEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-489-5730
Mailing Address - Fax:502-489-5753
Practice Address - Street 1:4002 KRESGE WAY
Practice Address - Street 2:SUITE 124
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4661
Practice Address - Country:US
Practice Address - Phone:502-895-4263
Practice Address - Fax:502-899-5488
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17382207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2434787000OtherPASSPORT ADVANTAGE / NMA
000052155COtherHUMANA / NMA
1069625OtherPASSPORT / NMA
KY64173826Medicaid
000000350554OtherANTHEM / NMA
1193930OtherCHA / NMA
2553922001OtherCIGNA / NMA
009111OtherSIHO / NMA
KYP00181564OtherRAILROAD MEDICARE
2434787000OtherPASSPORT ADVANTAGE / NMA
009111OtherSIHO / NMA