Individual
THOMAS SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6000
Mailing address
PO BOX 6790, CHESTERFIELD, MO 63006-6790
(314) 821-1256
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2009017025
MO
Other
Enumeration date
08/12/2009
Last updated
02/25/2014
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