Provider Demographics
NPI:1417038910
Name:SHAW, ALICE TSANG (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:TSANG
Last Name:SHAW
Suffix:
Gender:F
Credentials:MD PHD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIANS ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-4000
Mailing Address - Fax:617-726-0451
Practice Address - Street 1:100 BLOSSOM STREET COX 201
Practice Address - Street 2:HEMATOLOGY ONCOLOGY ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2617
Practice Address - Country:US
Practice Address - Phone:617-724-6862
Practice Address - Fax:617-726-0451
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2012-11-19
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Provider Licenses
StateLicense IDTaxonomies
MA210689207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2086450Medicaid
MA469913OtherTUFTS HEALTH PLAN
MAJ28176OtherBCBS MA
MAJ28176OtherBCBS MA
I19226Medicare UPIN