Provider Demographics
NPI:1891282547
Name:SHAO, KIMBERLY RACHEL (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:RACHEL
Last Name:SHAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:355 UNION BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1508
Mailing Address - Country:US
Mailing Address - Phone:720-915-5343
Mailing Address - Fax:720-615-4812
Practice Address - Street 1:355 UNION BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1508
Practice Address - Country:US
Practice Address - Phone:720-915-5343
Practice Address - Fax:720-615-4812
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2024-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.144767207ND0101X, 207N00000X
NY324374207ND0101X, 207N00000X
CODR.0070227207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology