Organization
CHARLES H. SHAW, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES H. SHAW M.D. (OWNER)
(419) 756-8511
Entity
Organization
Contact information
Practice address
370 CLINE AVE, MANSFIELD, OH 44907-1057
(419) 756-8511
(419) 756-8513
Mailing address
370 CLINE AVE, MANSFIELD, OH 44907-1057
(419) 756-8511
(419) 756-8513
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
OH
363LP0200X
Pediatric Nurse Practitioner
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0563840
—
OH
Enumeration date
02/20/2007
Last updated
02/28/2008
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