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Organization

RUSSEL K SHAW, MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RUSSEL K SHAW (OWNER/PHYSICIAN)
(407) 321-0060
Entity
Organization

Contact information

Practice address
247 SAN MARCOS AVE, SANFORD, FL 32771-1432
(407) 321-0060
(407) 323-2720
Mailing address
247 SAN MARCOS AVE, SANFORD, FL 32771-1432
(407) 321-0060
(407) 323-2720

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
02/17/2015
Last updated
02/17/2015
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