Dr. Brandon J Shaw, DO
Anesthesiology in Phoenix, AZ. Individual provider (NPI-1).
NPI number1073545877
StatusActive
Last updated in NPPESMar 6, 2025
Details
- NPI
- 1073545877
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brandon J Shaw
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 6, 2006
- Certification date
- Mar 6, 2025
- Last updated
- Mar 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | O2026 | ID | Yes |
| 207L00000X | Anesthesiology | 23217 | CA | |
| 207L00000X | Anesthesiology | L4710 | TX | |
| 207L00000X | Anesthesiology | 4067 | AZ | |
| 207LP2900X | Anesthesiology, Pain Medicine | 4067 | AZ |
Practice location
322 W Berridge LnPhoenix, AZ 85013-1547
Phone 602-300-9699
Mailing address
322 W Berridge LnPhoenix, AZ 85013-1547
Phone 602-300-9699
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