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Individual

MARIANNE L SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
154 HOSPITAL DR, TYRONE, PA 16686
(814) 684-6341
(814) 684-6343
Mailing address
154 HOSPITAL DR, TYRONE, PA 16686
(814) 684-6341
(814) 684-6343

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD4238723
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007706880003
PA
01
338517
BLUE SHIELD
PA
Enumeration date
07/22/2005
Last updated
08/02/2024
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