Provider Demographics
NPI:1790964633
Name:SHAO, DAWEI (DOM)
Entity Type:Individual
Prefix:DR
First Name:DAWEI
Middle Name:
Last Name:SHAO
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6709 TESOSO PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113
Mailing Address - Country:US
Mailing Address - Phone:505-918-7075
Mailing Address - Fax:505-221-5157
Practice Address - Street 1:3901 GEORGIA ST NE STE C2
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-918-7075
Practice Address - Fax:505-221-5157
Is Sole Proprietor?:No
Enumeration Date:2007-10-28
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM951171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist