Peter K Shaw, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD9819 Issued in ME

Practice address

331 Veranda St
Portland, ME 04103-5545

Phone

(207) 828-2402

Fax

(207) 828-2425

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1851361398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-791-3888",
            "fax_number": "207-828-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 VERANDA ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035545",
            "telephone_number": "207-828-2402",
            "fax_number": "207-828-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "PETER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "MD9819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111080099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bernadette H Shaw, PA-C
• Jacie Shaw
• Javere Shaw, LMT
• Jill Shaw, LCPC
• Nancy E Shaw, LCPC
• Samuel Shaw
• Steven Scott Shaw, D.M.D.
• David Shawkat
• Shawn Gebhardt LCPC Inc.
• Shaws Supermarkets Inc

• Cardiovascular Disease Physician in Portland, ME
• Providers in Portland, ME by specialty
• Cardiovascular Disease Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.