Individual
DR. JONATHAN DAVID SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2911 BRUNSWICK ROAD, MEMPHIS, TN 38133
(901) 377-4700
Mailing address
PO BOX 415000 MSC7548, NASHVILLE, TN 37241-7548
(901) 377-4700
(901) 377-4752
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
36677
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00877855
—
MS
05
—
Q008619
—
TN
Enumeration date
09/19/2006
Last updated
06/01/2018
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