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Individual

LINCOLN SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2600 N MAYFAIR RD STE 901, MILWAUKEE, WI 53226-1307
(773) 702-3937
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
125.070375
IL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
81248
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/25/2017
Last updated
03/01/2024
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