Individual
DONALD D SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
32-36 CENTRAL AVE, WELLSBORO, PA 16901-1840
(570) 723-0140
(570) 724-6541
Mailing address
32-36 CENTRAL AVE, WELLSBORO, PA 16901-1840
(570) 723-0140
(570) 724-6541
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
OS004233L
PA
207PS0010X
Sports Medicine (Emergency Medicine) Physician
OS004233L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007174090001
—
PA
01
—
217744
UPMC
PA
01
—
SH145926
BC/BS
PA
Enumeration date
08/03/2006
Last updated
04/16/2008
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