Individual
MICHAEL COURTNEY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 POWDERHORN RD, SIMPSONVILLE, SC 29681-3399
(864) 963-3421
Mailing address
20 POWDERHORN RD, SIMPSONVILLE, SC 29681-3399
(864) 963-3421
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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