# MITCHELL SHAW P A

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MITCHELL J. SHAW, D.O. PA.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326294042
- **Authorized official:** DR. MITCHELL J. SHAW D.O. (ADMINISTRATOR)
- **Authorized official phone:** (239) 394-4111

## Contact information

- **Practice address:** 19 BALD EAGLE DR, SUITE B, MARCO ISLAND, FL 34145-3580
- **Practice address phone:** (239) 394-4111
- **Mailing address:** 19 BALD EAGLE DR, SUITE B, MARCO ISLAND, FL 34145-3580
- **Mailing address phone:** (239) 394-4111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/13/2008
- **Last updated:** 10/17/2008