Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 204785 | MA |
N | 111NI0900X | Internist | 204785 | MA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 204785 | MA |
NPI | 1003921636 |
---|---|
Provider Name | Dr. Stanley Yang Shaw |
First Address | Brookline, MA 02445-6007 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 26/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
204785 | TUFTS HEALTH PLAN (01) | MA |
3208354 | (05) | MA |
H14743 | (02) | |
J22338 | BCBS (01) | MA |