Individual
DR. JUSTIN M SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
485 ROYER DRIVE, SUITE 103, LANCASTER, PA 17601-5102
(717) 560-4020
(717) 560-2919
Mailing address
485 ROYER DRIVE, SUITE 103, LANCASTER, PA 17601-5102
(717) 560-4020
(717) 560-2919
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD454562
PA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
MD454562
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030216600001
—
PA
Enumeration date
05/18/2010
Last updated
12/08/2020
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