# KIMBERLEE SHAW

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1245436203
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 141280 | NC | Yes |

## Other

- **Enumeration date:** 06/26/2007
- **Last updated:** 04/22/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 141280 | RTL | NC |
| 05 | — | 5915807 | — | NC |
| 01 | — | 9449525 | AETNA | NC |