Individual
KATHRYN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 HOSPITAL DR, DEPARTMENT OF EMERGENCY MEDICINE, MONROE, NC 28112-6000
(980) 993-3100
Mailing address
600 HOSPITAL DR, DEPARTMENT OF EMERGENCY MEDICINE, MONROE, NC 28112-6000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2011-01551
NC
207P00000X
Emergency Medicine Physician
243796
MA
207P00000X
Emergency Medicine Physician
MD13124
RI
207P00000X
Emergency Medicine Physician
MD36576
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001825402
MEDICARE PTAN
RI
05
—
110086818A
—
MA
05
—
KS82252
—
RI
Enumeration date
04/16/2007
Last updated
05/21/2015
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