# GARY Y SHAW MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669624896
- **Authorized official:** DR. GARY Y SHAW M.D. (PRESIDENT)
- **Authorized official phone:** (816) 524-4890

## Contact information

- **Practice address:** 296 NE TUDOR RD, LEES SUMMIT, MO 64086-5696
- **Practice address phone:** (816) 524-4890
- **Practice address fax:** (816) 524-4888
- **Mailing address:** 296 NE TUDOR RD, LEES SUMMIT, MO 64086-5696
- **Mailing address phone:** (816) 524-4890
- **Mailing address fax:** (816) 524-4888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 109774 | MO | Yes |

## Other

- **Enumeration date:** 10/21/2008
- **Last updated:** 10/21/2008