Shaw, Isaac Bernard

Shaw, Isaac Bernard is an individual health care provider with primary practice located at 3601 Sw 160Th Ave Suite 250, Miramar FL 33027-6308. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Shaw, Isaac Bernard can be contacted via phone (877) 866-7123.

Contact Information

Primary practice address
3601 Sw 160Th Ave Suite 250 Miramar FL 33027-6308
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 35.051823 Ohio
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35.051823 Ohio

Profile Details

NPI number 1669552600
LBN Legal business name Shaw, Isaac Bernard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Oct 13th, 2011 - about 13 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 1669552600 NPPES
New Mexico MEDICAID 000K3526
New Mexico Other HSZ196
New Mexico MEDICAID 25829823
New Mexico Other 8HL317

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