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General NPI Number Information
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NPI Number | 1720360746
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Entity Type | Individual
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Provider Name | LESLIE S SHAW NP
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Gender | Female
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 2340 SPRING FOREST RD
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City | RALEIGH
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State | NC
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Zip | 27615-7528
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Country | US
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Telephone | 866-389-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 2 LUCILLE LN
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City | CHERRY HILL
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State | NJ
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Zip | 08003-1031
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Country | US
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Telephone | 609-206-7872
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 24194163
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F357693-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26NJ00345100
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 27132
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17231-33
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 123764
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License Number State | WV
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5021999
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 203019
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License Number State | ND
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11860
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License Number State | CT
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Taxonomy #10
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | GAA-NP003835
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License Number State | GA
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Taxonomy #11
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | SP016443
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License Number State | PA
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Taxonomy #12
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | CP003764
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License Number State | SD
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