Individual
MR. WALTER SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(410) 581-3000
Mailing address
1501 S. CLINTON ST CT 05-13, BALTIMORE, MD 21224
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
RN1040463
DC
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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