Individual
ANTHONY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2647
Mailing address
1010 N KANSAS ST, WICHITA, KS 67214-3124
(316) 293-2647
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
94-09956
KS
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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