Individual
MR. MICHAEL GERARD RICHARD SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, APRN
Contact information
Practice address
5325 ELLIOTT DR FL 2, YPSILANTI, MI 48197-8633
(734) 712-8000
(734) 712-8010
Mailing address
315 TRESTLE DR, HOWELL, MI 48843-5806
(313) 529-5975
Taxonomy
Speciality
Code
Description
License number
State
163WF0300X
Flight Registered Nurse
4704278668
MI
363LF0000X
Family Nurse Practitioner
Primary
4704278668
MI
Other
Enumeration date
02/24/2021
Last updated
03/26/2022
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