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NPI Code Detail

MEDICARE: DR. WILLIAM E SHAW JR. M.D.

MEDICARE:  DR. WILLIAM E SHAW JR. 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
1207W00000XOphthalmology Physician036085447IL
2207W00000XOphthalmology PhysicianME154015FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730149550
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM E SHAW JR. M.D.
Provider Business Mailing Address
First Line : 1353 N COURTENAY PKWY STE T
Second Line :
City : MERRITT ISLAND
State : FL
Zip : 32953-4463
Country : US
Telephone Number : 321-449-2966
Fax Number :
Provider Business Practice Location Address
First Line : 1353 N COURTENAY PKWY STE T
Second Line :
City : MERRITT ISLAND
State : FL
Zip : 32953-4463
Country : US
Telephone Number : 321-449-2966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 02/06/2026

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Directions to “ DR. WILLIAM E SHAW JR. M.D.” Practice Location

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