Individual
DALTON GARRETT SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1920 W 1ST ST FL 3, WINSTON SALEM, NC 27104-4220
(336) 716-4479
Mailing address
7600 STATE HIGHWAY 16, SPARTA, WI 54656-4209
(715) 896-1395
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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