Individual
MR. RAYMOND SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC SAP
Contact information
Practice address
200 W 3RD ST, SUITE B, GREENVILLE, NC 27858-1808
(252) 413-0401
Mailing address
200 W 3RD ST, SUITE B, GREENVILLE, NC 27858-1808
(252) 413-0401
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
MHL-074-228
NC
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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