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Individual

SHAW P WAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1009 NORTH 6TH STREET, ALBEMARLE, NC 28001
(704) 982-2800
(704) 982-2830
Mailing address
1009 NORTH 6TH STREET, ALBEMARLE, NC 28001
(704) 982-2800
(704) 982-2830

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5903076
NC
Enumeration date
07/20/2006
Last updated
07/08/2007
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