NPI 1063973790
Cody Eugene Shaw
Practice location
- Address
- Numi Trout Ave Building 83, Groton, CT 06340
- Phone
- (860) 694-2876
- Mailing address
- 5 Wells St, Groton, CT 06340-3336
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1063973790
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 26 Mar 2019
- Record last updated
- 26 Mar 2019
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.