Shaw, Jonathan David

Shaw, Jonathan David is an individual health care provider with primary practice located at 2911 Brunswick Road , Memphis TN 38133. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Shaw, Jonathan David can be contacted via phone (901) 377-4700.

Contact Information

Primary practice address
2911 Brunswick Road Memphis TN 38133
Phone: (901) 377-4700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 36677 Tennessee

Profile Details

NPI number 1669579116
LBN Legal business name Shaw, Jonathan David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2006
Last updated Jun 1st, 2018 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1669579116 NPPES
Mississippi MEDICAID 00877855
Mississippi MEDICAID Q008619

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