Individual
DR. CHALYSE H. SHAW
Active
Individual
DR. CHALYSE H. SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
S01715PT
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390546
MAMSI
MD
01
—
M253CH
BLUECROSSBLUESHIELD
MD
01
—
R7290001
FEDERAL BLUECROSSSHIELD
MD
Enumeration date
01/06/2007
Last updated
05/12/2010
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