Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 233647 | MA |
N | 111NI0900X | Internist | 233647 | MA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 19673 | NH |
NPI | 1023283009 |
---|---|
Provider Name | Dr. Peter Wilson Shaw |
First Address | Manchester, NH 03102-3730 |
Second Address | Manchester, NH 03102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2008 |
Last Update Date | 02/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3117935 | (05) | NH |