Individual
DR. VANCE CLEVELAND SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 HIGH POINT DR, JOHNSON CITY, TN 37601-1503
(423) 631-0731
(423) 631-0732
Mailing address
205 HIGH POINT DR, JOHNSON CITY, TN 37601-1503
(423) 631-0731
(423) 631-0732
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD20911
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300121608
TAX ID
TN
Enumeration date
08/10/2006
Last updated
11/20/2015
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