Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 042731 | CT |
NPI | 1023016086 |
---|---|
Provider Name | Howard Andrew Shaw |
First Address | Hartford, CT 06105-1770 |
Second Address | Hartford, CT 06105-1770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 14/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042731 | (05) | CT |
E68796 | (02) | CT |