Individual
ANGELA C SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1300 E CENTENNIAL DR, PITTSBURG, KS 66762-6650
(620) 230-0044
(620) 230-0543
Mailing address
1 MT CARMEL WAY, PITTSBURG, KS 66762-7587
(620) 230-0044
(620) 230-0543
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0530788
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200052810A
—
OK
05
—
200267370A
—
KS
Enumeration date
09/20/2006
Last updated
03/26/2020
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