Individual
DR. MAX G DESHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MA64037
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7326203
—
NJ
01
—
D07188900
CDS PHYSICIAN CERT
NJ
01
—
MA64037
NJ STATE LICENSE
NJ
Enumeration date
06/11/2006
Last updated
09/24/2024
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