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Individual

DR. GERALD P SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
18301 N 79TH AVE, STE C126, GLENDALE, AZ 85308-8463
(623) 486-3346
(623) 486-3747
Mailing address
8004 W DONALD DR, PEORIA, AZ 85383-2114
(602) 405-5627
(623) 486-3747

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10342
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
260282
AZ
01
AZ0871340
BCBS OF AZ
AZ
Enumeration date
11/28/2006
Last updated
02/16/2009
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