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DR. MARY JO SHAW MD NPI 1316957202


NPI Information

NPI: 1316957202
Provider Name: DR. MARY JO SHAW, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
700 W IRONWOOD DR
SUITE 155
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 667-0585
Get Directions

DR. Mary Jo Shaw, MD is a pediatrics in Coeur D Alene, ID. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Mary Jo Shaw, MD NPI is 1316957202. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

700 W IRONWOOD DR
SUITE 155
COEUR D ALENE, ID
ZIP 83814-656
Phone: (208) 667-0585
Fax: (208) 667-0876

The enumeration date for this NPI number is 8/9/2006 and was last updated on 12/18/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsM5325IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000010000163OTHERIDAHOREGENCE BLUE SHIELD
2C36989MEDICARE UPINIDAHO
31120047MEDICARE ID-TYPE UNSPECIFIEDIDAHO
4000396600MEDICAIDIDAHO
51040476MEDICAIDWASHINGTON
6000010000162OTHERIDAHOREGENCE BLUE SHIELD
7DF474OTHERIDAHOBLUE CROSS OF IDAHO
853256OTHERIDAHOBLUE CROSS OF IDAHO
91316957202MEDICAIDMONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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