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Individual

DR. CHRISTIANA MARIE SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, GAINSVILLE, FL 32610-3003
(352) 265-0604
(352) 265-0190
Mailing address
PO BOX 918026, ORLANDO, FL 32891-8025
(352) 265-0604
(352) 265-0190

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME107446
FL
2086X0206X
Surgical Oncology Physician
MD433729
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002451200
FL
05
1021778180001
PA
Enumeration date
03/30/2007
Last updated
09/28/2010
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