MEDICARE: HILARY SHAW R.D., L.P.C.

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	133V00000X	Registered Dietitian	1340	LA

General Provider Information

NPI Number	:	1851671440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILARY SHAW R.D., L.P.C.

Provider Business Mailing Address
First Line	:	717 S FOSTER DR STE 140
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-5943
Country	:	US
Telephone Number	:	225-288-1999
Fax Number	:

Provider Business Practice Location Address
First Line	:	717 S FOSTER DR STE 140
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-5943
Country	:	US
Telephone Number	:	225-288-1999
Fax Number	:

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

Provider Enumeration Date	:	08/26/2011
Last Update Date	:	08/26/2011

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