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General NPI Number Information
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NPI Number | 1073975835
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Entity Type | Individual
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Provider Name | GREGORY AUGUSTINE SHAW ARNP
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Gender | Male
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 1300 MICCOSUKEE RD HOSPITALISTS GROUP
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5054
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Country | US
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Telephone | 850-431-4556
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Fax | 850-431-6315
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Provider Business Mailing Address
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Address Line | 1300 MICCOSUKEE RD HOSPITALISTS GROUP
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5054
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Country | US
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Telephone | 850-431-4556
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Fax | 850-431-6315
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 9309633
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License Number State | FL
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