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Individual
MR. SCOTT WARREN SHAW
Active
Individual
MR. SCOTT WARREN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001227
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010039746
—
VA
01
—
068270
ANTHEM BCBS
VA
01
—
3500352501
RAILROAD MEDICARE
VA
01
—
4400229
UNITED HEALTHCARE
VA
01
—
4546701
AETNA
VA
Enumeration date
08/22/2006
Last updated
07/14/2010
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