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Individual

DR. ISAAC BERNARD SHAW

Active
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Individual

DR. ISAAC BERNARD SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.051823
OH
208D00000X
General Practice Physician
35.051823
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
05
—
25829823
—
NM
01
—
8HL317
MEDICARE PROVIDER#
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
10/16/2006
Last updated
10/13/2011
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