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NPI Code Detail

MEDICARE: JO ANN G. SHAW M.D.

MEDICARE: JO ANN G. 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
1174400000XSpecialist32287NC

General Provider Information

NPI Number : 1346235413
Entity Type Code : Individual
Provider Name (Legal Business Name) : JO ANN G. SHAW M.D.
Provider Business Mailing Address
First Line : PO BOX 13508
Second Line :
City : GREENSBORO
State : NC
Zip : 27415-3508
Country : US
Telephone Number : 336-271-4930
Fax Number : 336-271-8466
Provider Business Practice Location Address
First Line : 1200 N ELM ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1004
Country : US
Telephone Number : 336-271-4930
Fax Number : 336-271-8466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 04/11/2008

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