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Contact Information

JEFFREY L SHAW, MD
1821 S WEBSTER AVE
GREEN BAY, WI54301
 Phone: 920-496-4700
 Fax: 920-431-1914
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for JEFFREY L SHAW · (Male)

NPI Number 1124083712
Status Active
Credentials MD
Entity Individual
Enumeration date 04/18/2006
Last updated 01/12/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 42113-020
  • WV License # 20844
  • WV License # 20884
  • KY Medicaid 64049158
  • OH Medicaid 2324505
  • WV Medicaid 1840670000
Hospital affiliation(s)
  • ST VINCENT HSPTL - (Acute Care)
    835 S VAN BUREN ST
    GREEN BAY, WI 54301
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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