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Justin Shaw
NPI 1255675237 · on the registry since 2012
Practice
- Address
- 3079 28th St Se
Kentwood, MI 49512 - Phone
- (616) 942-0795
- Fax
- (616) 942-0901
Registry record
- Primary taxonomy
- 237700000X
237700000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-11-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan