Organization
SHAW EYE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERT SHAW OD (OWNER)
(419) 536-9294
Entity
Organization
Contact information
Practice address
5821 W CENTRAL AVE, TOLEDO, OH 43615-1403
(419) 536-9294
(419) 536-9340
Mailing address
7613 SHADYWOOD LN, SYLVANIA, OH 43560-1869
(419) 536-9294
(419) 536-9340
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3892/T648
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900E810850
BCBS OF MI
MI
Enumeration date
05/16/2008
Last updated
11/23/2010
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