Individual
KRISTA L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCADC
Contact information
Practice address
4949A ALBEMARLE RD, CHARLOTTE, NC 28205-6617
(918) 289-0270
Mailing address
132 FOREST OAKS DR, IRON STATION, NC 28080-9613
(918) 289-0270
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
CADC-29393
NC
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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