Organization
DR. MICHAEL P. SHAW, A PROFESSIONAL CORPORATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH S. SHAW (PRACTICE ADMINISTRATOR)
(209) 667-9339
Entity
Organization
Contact information
Practice address
2020 STANDIFORD AVE STE B, MODESTO, CA 95350-6530
(209) 522-9339
(209) 525-9366
Mailing address
222 MEMORY LN, TURLOCK, CA 95382-7272
(209) 667-9339
(209) 664-0505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35996
CA
Other
Enumeration date
03/04/2009
Last updated
03/04/2009
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