Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2011015519 | MO |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 2011015519 | MO |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 2011015519 | MO |
N | 208200000X | Surgeon | 5914 | NE |
N | 208600000X | Surgeon | 5914 | NE |
NPI | 1497917991 |
---|---|
Provider Name | Christopher Michael Shaw |
First Address | Kansas City, MO 64108-2602 |
Second Address | Kansas City, MO 64108-2727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 18/11/2020 |