Individual
SAMANTHA L SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
393 VINEWOOD AVE, TALLMADGE, OH 44278-1350
(330) 515-6403
Mailing address
393 VINEWOOD AVE, TALLMADGE, OH 44278-1350
(330) 515-6403
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.009914RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2025
Last updated
03/12/2026
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