Individual
DWAYNE LEON SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1145 W GRAND BLVD, DETROIT, MI 48208-2336
(313) 324-8900
(314) 324-8900
Mailing address
80 E HANCOCK ST APT 305, DETROIT, MI 48201-1325
(313) 957-9234
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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