Individual
JONATHAN STEPHEN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6401 PRAIRIE ST STE 1700, NORTON SHORES, MI 49444-7843
(231) 672-7944
(231) 672-7994
Mailing address
PO BOX 776982, CHICAGO, IL 60677-6982
(800) 494-5797
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
18596
NH
207V00000X
Obstetrics & Gynecology Physician
EMC0002741
MI
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
EMC0002741
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13566727944
—
MI
Enumeration date
01/25/2010
Last updated
08/10/2023
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