NPI 1023497344

Jacob Israel Shaw, MD

Practitioner Family Medicine Physician Burlington, VT

Practice location

Address: 789 Pine St, Burlington, VT 05401-4924
Phone: (802) 864-0693
Fax: (028) 606-6138
Mailing address: 617 Riverside Ave, Burlington, VT 05401-1601

Registered specialties (2)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 036144497 (IL)

Other Family Medicine providers in Vermont →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1023497344
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 May 2015
Record last updated: 11 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.