Individual
JANE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
416 ALBEMARLE SQ, CHARLOTTESVILLE, VA 22901-7400
(434) 978-2126
(434) 973-4452
Mailing address
416 ALBEMARLE SQ, CHARLOTTESVILLE, VA 22901-7400
(434) 978-2126
(434) 973-4452
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101048714
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005638631
—
VA
01
—
080141642
MEDICARE PIN
VA
01
—
142736
SOUTHERN HEALTH
VA
01
—
234066
ANTHEM SVC/HEALTHKEEPERS
VA
01
—
267131
MAMSI
VA
01
—
45186
COMMUNITY HEALTH
VA
01
—
700010936
CIGNA
VA
Enumeration date
02/15/2006
Last updated
04/19/2012
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