Shaw, E Carl
Shaw, E Carl is an sole proprietor health care provider with primary practice located at 1267 Russell Pkwy , Warner Robins GA 31088-5582. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Shaw, E Carl can be contacted via phone (478) 923-0253.Contact Information
Primary practice address
1267 Russell Pkwy
Warner Robins GA 31088-5582
Phone: (478) 923-0253
Fax: (478) 923-6906
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DN008543 | Georgia |
Profile Details
| NPI number | 1366505265 |
|---|---|
| LBN Legal business name | Shaw, E Carl |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1366505265 | NPPES |
| Georgia | MEDICAID | 00311341A |
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