Provider Demographics
NPI:1881896553
Name:SHAW-KAIKAI, JOANNA ETHEL TAHSIO (MD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:ETHEL TAHSIO
Last Name:SHAW-KAIKAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:ETHEL TAHSIO
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2500 CHARLOTTE AVE
Mailing Address - Street 2:TB ELIMINATION
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4129
Mailing Address - Country:US
Mailing Address - Phone:615-340-5650
Mailing Address - Fax:615-340-8973
Practice Address - Street 1:2500 CHARLOTTE AVE
Practice Address - Street 2:TB ELIMINATION
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4129
Practice Address - Country:US
Practice Address - Phone:615-340-5650
Practice Address - Fax:615-340-8973
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNM0000044802207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0026125OtherINSTITUTIONAL PERMIT