Individual provider Active NPI

Steven Michael Shaw, MD

  • Procedural Dermatology Physician
  • Tucson, AZ
National Provider Identifier
1790418200
Registry record updated Jul 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
15173 Issued in AZ
Practice address
6913 N Gleneagles Dr
Tucson, AZ 85718-1844
Phone
(520) 299-8095
Fax
(530) 577-6787
NPI assigned
Jul 3, 2022
Last updated
Jul 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 15173 AZ Primary

Addresses

Primary practice location

6913 N Gleneagles Dr
Tucson, AZ 85718-1844

Mailing address

6913 N Gleneagles Dr
Tucson, AZ 85718-1844
Phone (520) 299-8095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15173AZMDProcedural Dermatology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656806400000",
    "number": "1790418200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6913 N GLENEAGLES DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181844",
            "telephone_number": "520-299-8095",
            "fax_number": "530-577-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6913 N GLENEAGLES DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181844",
            "telephone_number": "520-299-8095",
            "fax_number": "530-577-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-03",
        "last_updated": "2022-07-03",
        "certification_date": "2022-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "15173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.