Individual
MS. MARIAN E SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 N ROBBINS RD, SUITE 301, BOISE, ID 83702-4565
(208) 489-4900
(208) 489-4063
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
(208) 489-4063
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M5056
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000367000
—
ID
05
—
1841242641
—
ID
Enumeration date
05/17/2006
Last updated
01/09/2015
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