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Individual

DR. MICHAEL CHARLES SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4516 N ARMENIA AVE, TAMPA, FL 33603-2732
(813) 348-6951
(813) 348-6999
Mailing address
PO BOX 403444, ATLANTA, GA 30384-3444
(813) 348-6951
(813) 348-6999

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
ME38268
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME38268
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
069593900
FL
01
300032780
RR MCR
FL
Enumeration date
02/22/2006
Last updated
04/01/2010
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