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NPI Code Detail

MEDICARE: DR. MATHEW SHAW PHARMD

MEDICARE:  DR. MATHEW  SHAW  PHARMD
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
1183500000XPharmacistPS48850FL

General Provider Information

NPI Number : 1912507377
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATHEW SHAW PHARMD
Provider Business Mailing Address
First Line : 1590 DUNLAWTON AVE
Second Line :
City : PORT ORANGE
State : FL
Zip : 32127-4752
Country : US
Telephone Number : 386-761-0191
Fax Number : 386-761-1305
Provider Business Practice Location Address
First Line : 1590 DUNLAWTON AVE
Second Line :
City : PORT ORANGE
State : FL
Zip : 32127-4752
Country : US
Telephone Number : 386-761-0191
Fax Number : 386-761-1305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2020
Last Update Date : 10/27/2020

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Directions to “ DR. MATHEW SHAW PHARMD” Practice Location

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