Provider Demographics
NPI:1902816010
Name:SHRABERG, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SHRABERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 E MAXWELL ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2640
Mailing Address - Country:US
Mailing Address - Phone:859-263-4341
Mailing Address - Fax:859-263-7441
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:PAV A, H, & MARKEY
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-257-1000
Practice Address - Fax:859-323-1194
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY193852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64193857Medicaid
KYB60912Medicare UPIN
KY0978901Medicare ID - Type Unspecified