MEDICARE: ROBERT DAVID SHAW BC-HIS

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
1	237700000X	Hearing Instrument Specialist	CO08	CO

General Provider Information

NPI Number	:	1225955214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT DAVID SHAW BC-HIS

Provider Business Mailing Address
First Line	:	12585 ANGELINA DR
Second Line	:
City	:	PEYTON
State	:	CO
Zip	:	80831-8468
Country	:	US
Telephone Number	:	719-445-4994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 E WOODMEN RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3326
Country	:	US
Telephone Number	:	719-445-4994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2026
Last Update Date	:	07/01/2026

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