Shaw, Gary H
Shaw, Gary H is an sole proprietor health care provider with primary practice located at 416 Connable Ave , Petoskey MI 49770-2212. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Shaw, Gary H can be contacted via phone (231) 487-7303.Contact Information
Primary practice address
416 Connable Ave
Petoskey MI 49770-2212
Phone: (231) 487-7303
Fax: (231) 487-7313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 4301045389 | Michigan |
Profile Details
| NPI number | 1013921154 |
|---|---|
| LBN Legal business name | Shaw, Gary H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Sep 25th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013921154 | NPPES |
| Michigan | Other | GS045389 | BS STATE LIC# |
| Michigan | MEDICAID | 1013921154 | BS STATE LIC# |
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