Individual
DR. RENITA TA'SHA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1434 CENTRAL AVE E, WIGGINS, MS 39577-9602
(601) 928-6700
(601) 928-6731
Mailing address
1434 E CENTRAL AVE., STONE COUNTY HOSPITAL, WIGGINS, MS 39503
(601) 928-6700
(601) 928-6731
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
80199
MS
Other
Enumeration date
03/04/2009
Last updated
06/15/2012
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