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NPI Code Detail

MEDICARE: DAVID M SHAW M.D.

MEDICARE: DAVID M SHAW 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
1207RC0000XCardiovascular Disease Physician18111AL
2207RI0011XInterventional Cardiology Physician18111AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336120419
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID M SHAW M.D.
Provider Business Mailing Address
First Line : 1700 SPRING HILL AVE
Second Line : SUITE 100
City : MOBILE
State : AL
Zip : 36604-1407
Country : US
Telephone Number : 251-435-1200
Fax Number : 251-435-6357
Provider Business Practice Location Address
First Line : 1700 SPRING HILL AVE
Second Line : SUITE 100
City : MOBILE
State : AL
Zip : 36604-1407
Country : US
Telephone Number : 251-435-1200
Fax Number : 251-435-6357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 06/12/2012

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Directions to “ DAVID M SHAW M.D.” Practice Location

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