MICHAEL J SHAW (NPI# 1063499663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063499663 |
| Entity Type | Individual |
| Full Name | MICHAEL J SHAW |
| Practice Address |
3800 Park Nicollet Blvd Park Nicollet Clinic - Gastro St Louis Park MN 55416-2527 |
| Mailing Address |
6465 Wayzata Blvd Ste 315 St Louis Park MN 55426-1728 |
| Practice Telephone | 9529933240 |
| Practice Fax Number | 9529931865 |
| Mailing Telephone | 9529937169 |
| Mailing Fax Number | 9529930300 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2012-07-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
25905 | MN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972150191 | Michael Alfred Shaw | Pharmacist | 102 E Commerce, Crowell, TX 79227 | 2019-08-22 |
| 1073058020 | Michael George Shaw | Nurse Practitioner | 23 Pebble Hill Dr, Brandon, MS 39042-2140 | 2016-12-29 |
| 1356782791 | Michael Jay Shaw | Counselor | 3900 Bluebonnet Ln, Milford, TX 76670-1259 | 2013-07-15 |
| 1659416626 | Michael M Shaw | Counselor | 2425 Chatlin Road, Holiday, FL 34691 | 2007-02-20 |
| 1609979863 | Michael M Shaw | Chiropractor | 3000 Carlisle, Suite 206, Dallas, TX 75204 | 2006-09-06 |
| 1679594113 | Michael P. Shaw | Dentist | 2020 Standiford Ave Ste B, Modesto, CA 95350-6530 | 2006-07-21 |
| 1134109358 | Michael B Shaw | Otolaryngology | 4230 W 83rd St, Tulsa, OK 74132-3020 | 2006-01-23 |
| 1831715044 | Michael Shaw | Dentist | 1500 Horizon Dr Ste 104, Chalfont, PA 18914-3966 | 2020-06-23 |
| 1861969412 | Michael Ed Shaw | Physician Assistant | 130 Fisher Rd, Berlin, VT 05602-9516 | 2018-10-31 |
| 1447638267 | Michael Shaw | Anesthesiology | 301 University Blvd # 2-a, Galveston, TX 77555-0591 | 2015-05-13 |
| Street Address |
3800 PARK NICOLLET BLVD PARK NICOLLET CLINIC - GASTRO |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497745 | Mary C Fields | Psychiatry & Neurology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-06-16 |
| 1316552383 | Emily Elizabeth Morimoto | Psychologist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-09-15 |
| 1245862846 | Caara Hirsch Leintz | Physician Assistant | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-02-11 |
| 1477102770 | Kyja Foster | Counselor | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-09-09 |
| 1750938411 | Abigale Jayne Harris | Social Worker | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-19 |
| 1912552076 | Michael Patrick Miller | Dietitian, Registered | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-06 |
| 1083277743 | Jessica B Arndt | Social Worker | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-04-18 |
| 1043785157 | Jerry L Juhl | Physical Therapist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-10-05 |
| 1437624558 | Chandler Elise Domian Ommen | Occupational Therapist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-10-04 |
| 1861977472 | Sarah Ruth Tupper | Nurse Practitioner | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851331441 | James S Mallery | Internal Medicine | 6500 Excelsior Blvd Suite 4-820, Digestive and Endoscopy Center Methodist Hospital, St Louis Park, MN 55426 | 2006-06-08 |
| 1275972341 | Andrew J. Henn | Internal Medicine | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2013-06-21 |
| 1770619967 | Leticia Perondi Luz | Internal Medicine | 6500 Excelsior Blvd, Suite4-820, St Louis Park, MN 55426-4702 | 2007-02-24 |
| 1568484608 | Anne Kathryn Nagler | Internal Medicine | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2006-07-25 |
| 1043297039 | Steven Olsson | Internal Medicine | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-29 |
| 1639156243 | David Stolpman | Internal Medicine | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-23 |
| 1982681631 | Laura Stahnke | Internal Medicine | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-23 |
| 1922083740 | Michael Levy | Internal Medicine | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-14 |
| 1528043973 | Hugh Edmondson | Internal Medicine | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-08 |
| 1871578419 | Ann M Kools | Internal Medicine | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-12-07 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.