Provider Demographics
NPI:1194781260
Name:REESMAN, SHAWN D (MD)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:D
Last Name:REESMAN
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:ASSOCIATED RADIOLOGISTS, INC.
Mailing Address - Street 2:1120 KANAWHA BLVD E
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-2400
Mailing Address - Country:US
Mailing Address - Phone:304-344-3457
Mailing Address - Fax:304-344-3480
Practice Address - Street 1:1710 HARPER ROAD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:540-345-3556
Practice Address - Fax:540-342-2193
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV190662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001720229OtherMTN STATE BCBS
WV7200010000Medicaid
H02101Medicare UPIN