Individual
SUZANNE L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3000 15TH AVE SOUTH, GREAT FALLS, MT 59405
(406) 454-2171
(406) 771-3021
Mailing address
1400 29TH ST S, GREAT FALLS, MT 59405-5353
(406) 454-2171
(406) 771-3021
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
7782
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072371
—
MT
Enumeration date
09/02/2005
Last updated
08/08/2011
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