| Dana Shaw Llc | |
|
822 Guilford Ave Ste 802 Baltimore MD 21202-3707 | |
| (443) 203-8566 | |
| Not Available |
| Full Name | Dana Shaw Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 822 Guilford Ave Ste 802, Baltimore, Maryland |
| Authorized Official Name and Position | Dana Vinyard Shaw (OWNER) |
| Authorized Official Contact | 4432038566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dana Shaw Llc 822 Guilford Ave Ste 802 Baltimore MD 21202-3707 Ph: (443) 203-8566 | Dana Shaw Llc 822 Guilford Ave Ste 802 Baltimore MD 21202-3707 Ph: (443) 203-8566 |
| NPI Number | 1578171088 |
|---|---|
| Provider Enumeration Date | 07/21/2020 |
| Last Update Date | 07/21/2020 |
| Certification Date | 07/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578171088 | NPI | - | NPPES |
| 1245626191 | Other | MD | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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