Individual
LINDA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5347
(314) 268-4015
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5347
(314) 268-4015
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2012004803
MO
208000000X
Pediatrics Physician
25MA05358000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3859908
—
NJ
Enumeration date
07/27/2006
Last updated
01/13/2021
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