Individual
DAVID L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11155 DUNN RD, SUITE 205E, SAINT LOUIS, MO 63136-6150
(314) 355-1660
(314) 355-2807
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 355-1660
(314) 355-2807
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
108388
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010051
ESSENCE
MO
01
—
0406305
UHC
MO
01
—
116062
BCBS
MO
01
—
138767
GHP
MO
05
—
209781301
—
MO
01
—
407737
HEALTLINK
MO
01
—
7486026
AETNA
MO
01
—
G73848
MERCY
MO
Enumeration date
11/16/2005
Last updated
09/28/2012
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