Whalio Doctors

NPI 1124083712

Jeffrey L Shaw, MD

Practitioner Allergy & Immunology Physician Green Bay, WI

Practice location

Address
1821 S Webster Ave, Green Bay, WI 54301
Phone
(920) 496-4700
Fax
(920) 431-1914
Mailing address
PO Box 19070, Green Bay, WI 54307-9070

Registered specialties (3)

Allergy & Immunology Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 207K00000X Licence 42113-020 (WI)
Allergy & Immunology Physician
Allopathic & Osteopathic Physicians Taxonomy 207K00000X Licence 20844 (WV)
Pediatrics Physician
Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 20884 (WV)

Registry record

NPI
1124083712
Entity type
Individual
Sex (as registered)
Male
NPI issued
18 Apr 2006
Record last updated
12 Jan 2017

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.