Individual
DAVID MICHAEL SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7910 FROST ST, SUITE 245, SAN DIEGO, CA 92123-2771
(858) 650-5036
(858) 650-5039
Mailing address
8555 AERO DR, STE 104, SAN DIEGO, CA 92123-1744
(858) 650-5036
(858) 650-5039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A61780
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A61780
CA
207RP1001X
Pulmonary Disease Physician
A61780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8394967
—
WA
01
—
P00188366
RR MEDICARE
WA
Enumeration date
08/30/2005
Last updated
04/06/2020
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