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Individual

SPENCER SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
30 GREENRIDGE AVE, WHITE PLAINS, NY 10605-1237
(914) 328-8555
(914) 593-7881
Mailing address
PO BOX 5801, NEW YORK, NY 10087-5801
(914) 593-7880
(914) 593-7881

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
109224
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00600058
RR MEDICARE
NY
Enumeration date
08/04/2006
Last updated
04/03/2009
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