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Individual
TRAVIS LARON SHAW
Active
Individual
TRAVIS LARON SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
0101245920
VA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
0101245920
VA
Other
Enumeration date
05/31/2007
Last updated
01/29/2013
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