Individual
MR. MICHAEL DUDLEY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
2138 MENDON RD, #302, CUMBERLAND, RI 02864-3834
(401) 334-0218
(401) 334-9531
Mailing address
725 RESERVOIR AVE, #101, CRANSTON, RI 02910-4448
(401) 944-3800
(401) 944-1342
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01331
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003802943
DURABLE
RI
01
—
405638
BLUECHIP
RI
Enumeration date
09/26/2005
Last updated
01/26/2010
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