Individual
DR. JUDITH SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 WARREN AVE, SUITE 200, EAST PROVIDENCE, RI 02914-1430
(401) 421-6481
(401) 751-8734
Mailing address
10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 02903-4754
(401) 421-4000
(401) 272-1456
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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