Individual
JANE ANNE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
240 HOSPITAL DR NE, BOLIVIA, NC 28422-8346
(910) 721-2070
(910) 721-2074
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(910) 721-2070
(910) 721-2074
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
253702
NC
207R00000X
Internal Medicine Physician
0116027660
VA
207R00000X
Internal Medicine Physician
253702
NC
208M00000X
Hospitalist Physician
Primary
2019-02427
NC
Other
Enumeration date
10/15/2014
Last updated
10/10/2023
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