Individual
HOLLY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4 OLIVIA CT, MIDDLE RIVER, MD 21220-1180
(443) 834-5452
Mailing address
5233 KING AVE STE 208, BALTIMORE, MD 21237-4003
(410) 918-1525
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0009310
MD
Other
Enumeration date
03/25/2024
Last updated
09/17/2024
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