Individual
DR. JUSTINE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
455 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(505) 983-3361
Mailing address
455 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(505) 983-3361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2017-0679
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2014
Last updated
07/21/2022
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