Individual
DR. LEONARD S SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
44 MASON ST, BERLIN, NH 03570
(603) 752-6211
(603) 752-7645
Mailing address
44 MASON ST, BERLIN, NH 03570
(603) 752-6211
(603) 752-7645
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0225
NH
152W00000X
Optometrist
Primary
OPT584
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001300
ANTHEM
ME
05
—
108660000
—
ME
05
—
80587867
—
NH
Enumeration date
02/01/2006
Last updated
07/08/2008
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