Healthcare Provider Details

I. General information

NPI: 1669688784
Provider Name (Legal Business Name): SHAW R NATAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 03/13/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST CARDIOVASCULAR MEDICINE SUITE, 4TH FL MARGARET'S
BRIGHTON MA
02135
US

IV. Provider business mailing address

BMCHS PROVIDER ENROLLMENT 960 MASSACHUSETTS AVE FLR 2
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-562-7690
  • Fax: 617-562-7699
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD422744
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number235960
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: