Provider Demographics
NPI:1881645752
Name:SHAW, BYERS W (MD)
Entity Type:Individual
Prefix:
First Name:BYERS
Middle Name:W
Last Name:SHAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:402-559-8272
Mailing Address - Fax:402-559-6749
Practice Address - Street 1:988102 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-8102
Practice Address - Country:US
Practice Address - Phone:402-559-8272
Practice Address - Fax:402-559-6749
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE16948204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557580Medicaid
NE266229Medicare ID - Type Unspecified
NE47078557580Medicaid