Individual
MR. ANDREW BLAIR SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 N J ST, RICHMOND, IN 47374-1913
(765) 983-3298
(765) 983-7970
Mailing address
1100 REID PARKWAY, MEDICAL STAFF SERIVCES, RICHMOND, IN 47374-1157
(765) 935-8802
(765) 983-3219
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01083410A
IN
2084P0800X
Psychiatry Physician
9901029
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1218F
BCBS PROVIDER ID #
NC
01
—
188031
MEDCOST
NC
01
—
1982644175
UNITED HEATLCARE
NC
05
—
891218F
—
NC
Enumeration date
06/07/2006
Last updated
03/07/2023
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