Individual
MRS. MELISSA ANN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
267 GRANT STREET, DEPT OF PEDIATRICS, BRIDGEPORT, CT 06610
(203) 384-3199
Mailing address
267 GRANT STREET, DEPT OF PEDIATRICS, BRIDGEPORT, CT 06610
(203) 384-3199
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000672
CT
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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