Provider Demographics
NPI:1942438643
Name:SHAW, DARCY DONOVAN (MD)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:DONOVAN
Last Name:SHAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3460 NE RALPH POWELL RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2361
Mailing Address - Country:US
Mailing Address - Phone:816-246-0800
Mailing Address - Fax:816-246-0800
Practice Address - Street 1:1200 E MICHIGAN AVE STE 655
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1837
Practice Address - Country:US
Practice Address - Phone:517-267-2487
Practice Address - Fax:517-267-2488
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2022-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20160000804208600000X, 208C00000X
MI4301095056208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery