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RUSSEL K SHAW
247 SAN MARCOS AVE SANFORD FL 327711432

RUSSEL K SHAW is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1518914795. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 4284699737. The primary specialty is GENERAL SURGERY. The organization is . The address is 247 SAN MARCOS AVE, , SANFORD, FL, 327711432. The zip code is 327711432.


Nation Provider ID1518914795
PAC ID by PECOS4284699737
Professional Enrollment IDI20041123000934
NameRUSSEL K SHAW
Medical School NameUNIVERSITY OF SOUTHERN CALIFORNIA SCHOOL OF MEDICINE
Graduation Year1965
Primary SpecialtyGENERAL SURGERY
All secondary specialties
Organization Name
Group Practice PAC ID
Number of Group Practice members0
Address247 SAN MARCOS AVE, , SANFORD, FL, 327711432
Hospital affiliation LBNCENTRAL FLORIDA REGIONAL HOSPITAL, INC
Graduation Year1965
Contact Number4073210060
Email Address[Show_Email_ID]

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