Individual
DR. JUDITH SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD05989
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
709004047
GROUP MEDICARE
RI
05
—
JS01339
—
RI
Enumeration date
09/30/2005
Last updated
07/16/2012
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