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Individual
TARA A. SHAW
Active
Individual
TARA A. SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-113299
IL
207Q00000X
Family Medicine Physician
Primary
A80836
CA
207QS0010X
Sports Medicine (Family Medicine) Physician
A80836
CA
Other
Enumeration date
07/11/2006
Last updated
12/22/2021
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