MEDICARE: JOHN A SHAW MD PC

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	2085R0001X	Radiation Oncology Physician	AZ 14068	AZ

General Provider Information

NPI Number	:	1679632459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN A SHAW MD PC

Provider Business Mailing Address
First Line	:	10386 N 96TH PL
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4775
Country	:	US
Telephone Number	:	602-510-8100
Fax Number	:	480-391-1458

Provider Business Practice Location Address
First Line	:	2224 W NORTHERN AVE
Second Line	:	SUITE D-300
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4928
Country	:	US
Telephone Number	:	602-510-8100
Fax Number	:	480-391-1458

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN A SHAW II
Credential	:	M.D.
Telephone Number	:	602-510-8100

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	02/20/2013

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