Provider Demographics
NPI:1457443079
Name:SHAW, JAMES ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:SHAW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:CHARLOTTE
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-213-1500
Mailing Address - Fax:828-651-6570
Practice Address - Street 1:377 GALLIMORE RD
Practice Address - Street 2:BREVARD
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-8874
Practice Address - Country:US
Practice Address - Phone:828-884-9030
Practice Address - Fax:828-884-3563
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2022-02-09
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Provider Licenses
StateLicense IDTaxonomies
NC35197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC213592COtherMEDICARE PTAN
NC8975523Medicaid
NC0637660001OtherPALMETTO GOVERNMENT SERVI
NC561852981FOtherCIGNA
NCNCM996COtherMEDICARE PTAN
NC01-70577OtherUNITED HEALTHCARE
NC080084314OtherRAILROAD MEDICARE
NCNCM996BOtherMEDICARE PTAN
NC75523OtherBLUE CROSS BLUE SHIELD
NCNCM996AOtherMEDICARE PTAN
NC080084314OtherRAILROAD MEDICARE
NCD05521Medicare UPIN