Organization
GARY H. SHAW, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY H. SHAW M.D. (PRESIDENT)
(231) 487-2100
Entity
Organization
Contact information
Practice address
560 W MITCHELL ST, STE 505, PETOSKEY, MI 49770-2275
(231) 487-2100
(231) 487-6049
Mailing address
560 W MITCHELL ST, STE 505, PETOSKEY, MI 49770-2275
(231) 487-2100
(231) 487-6049
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301045389
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104092118
—
MI
Enumeration date
10/16/2007
Last updated
11/18/2009
Update your record
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