Shaw, Jacob Israel
Shaw, Jacob Israel is an individual health care provider with primary practice located at 789 Pine St , Burlington VT 05401-4924. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Shaw, Jacob Israel can be contacted via phone (802) 864-0693.Contact Information
Primary practice address
789 Pine St
Burlington VT 05401-4924
Phone: (802) 864-0693
Fax: (028) 606-6138
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036144497 | Illinois |
Profile Details
| NPI number | 1023497344 |
|---|---|
| LBN Legal business name | Shaw, Jacob Israel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2015 |
| Last updated | Feb 11th, 2021 - about 5 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.
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