Individual
DR. MANDY L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D,
Contact information
Practice address
900 CEDAR ST, JULESBURG, CO 80737-1121
(308) 249-6600
(970) 474-2758
Mailing address
900 CEDAR ST, JULESBURG, CO 80737-1121
(970) 474-3323
(970) 474-2758
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22592
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30482
BCBS OF NEBRASKA
NE
01
—
P00253777
RAILROAD MEDICARE
NE
Enumeration date
11/03/2006
Last updated
11/09/2025
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