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NPI Code Detail

MEDICARE: DR. ROBERT D SHAW JR. M.D.

MEDICARE:  DR. ROBERT D SHAW JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianR7A02MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184715724
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT D SHAW JR. M.D.
Provider Business Mailing Address
First Line : PO BOX 802843
Second Line :
City : KANSAS CITY
State : MO
Zip : 64180-2843
Country : US
Telephone Number : 417-730-6430
Fax Number : 417-269-7567
Provider Business Practice Location Address
First Line : 816 E MAIN ST
Second Line :
City : WILLOW SPRINGS
State : MO
Zip : 65793-1518
Country : US
Telephone Number : 417-269-2490
Fax Number : 417-269-2492
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 08/02/2023

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Directions to “ DR. ROBERT D SHAW JR. M.D.” Practice Location

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