Individual
COLLEEN R. SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
916 JACKSON AVENUE, SHERIDAN, WY 82801
(307) 675-5555
(307) 675-5599
Mailing address
916 JACKSON AVENUE, SHERIDAN, WY 82801
(307) 675-5555
(307) 675-5599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A114032
CA
208000000X
Pediatrics Physician
Primary
TL4426
WY
Other
Enumeration date
02/24/2011
Last updated
08/01/2018
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