Individual
NEIL SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1200 SIXTH ST STE 200, TRAVERSE CITY, MI 49684
(231) 935-5800
(231) 935-5799
Mailing address
224 CIRCLE DR, TRAVERSE CITY, MI 49684-2700
(231) 932-4912
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704286192
MI
Other
Enumeration date
06/30/2016
Last updated
09/05/2024
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