Individual
MATTHEW WAYNE SHAWL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
853 BROADWAY, SUITE 903, NEW YORK, NY 10003
(212) 787-6900
(917) 421-9786
Mailing address
853 BROADWAY, SUITE 903, NEW YORK, NY 10003
(212) 787-6900
(917) 421-9786
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
708640
—
207Y00000X
Otolaryngology Physician
Primary
208640
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02168963
—
NY
Enumeration date
05/05/2006
Last updated
12/23/2009
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