Provider Demographics
NPI:1740424704
Name:GAO, SHAWN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MICHAEL
Last Name:GAO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3535 S JEFFERSON AVE
Mailing Address - Street 2:STE. 118
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-3930
Mailing Address - Country:US
Mailing Address - Phone:314-776-7999
Mailing Address - Fax:314-772-2257
Practice Address - Street 1:3535 S JEFFERSON AVE
Practice Address - Street 2:STE. 118
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-3930
Practice Address - Country:US
Practice Address - Phone:314-776-7999
Practice Address - Fax:314-772-2257
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2015-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2014027747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine