DR. MY LE SHAW (NPI# 1467690131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467690131 |
| Entity Type | Individual |
| Full Name | DR. MY LE SHAW |
| Credential | M.D. |
| Practice Address |
14272 N Fenton Rd Fenton MI 48430-1544 |
| Mailing Address |
13189 Harborview Dr Linden MI 48451-9496 |
| Practice Telephone | 8107778326 |
| Mailing Telephone | 2066964062 |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2020-03-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 4301092625 | MI | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 35098937 | OH | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | TP347 | KY | Allopathic & Osteopathic Physicians |
| Y | 207WX0009X |
Ophthalmology Specialization: Glaucoma Specialist |
4301092625 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201065670 | 05 | |
| KY | 7100204870 | 05 | |
| BCBS (ANTHEM) | 000000761334 | 01 | |
| OH | 0065066 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4499 Town Center Pkwy, Flint, MI 485323425 | 2066964062 |
| Street Address |
14272 N FENTON RD |
| City | FENTON |
| State | MI |
| Zip Code | 48430-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750915393 | Eye Associates of Michigan, Plc | Ophthalmology | 14272 N Fenton Rd, Fenton, MI 48430-1544 | 2020-02-22 |
| 1558759183 | Primary Care Medicine, PC | Family Medicine | 14272 N Fenton Rd, Fenton, MI 48430-1544 | 2015-01-06 |
| 1902199862 | Christopher Iacobelli Md PC | Family Medicine | 14272 N Fenton Rd, Fenton, MI 48430-1544 | 2011-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1366994410 | Intentional Wellbeing LLC | Psychologist | 1122 N. Leroy Rd, Suite A, Fenton, MI 48430 | 2016-10-25 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 207WX0009X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Glaucoma Specialist |
| An ophthalmologist who specializes in the treatment of glaucoma and other disorders related to increased intraocular pressure and optic nerve damage. This specialty involves the medical and surgical treatment of these conditions. |
| Notes: Source: American Academy of Ophthalmology, www.aao.org [1/1/2017: new] Additional Resources: Association of University Professors of Ophthalmology, www.aupo.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750915393 | Eye Associates of Michigan, Plc | Ophthalmology | 14272 N Fenton Rd, Fenton, MI 48430-1544 | 2020-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942794797 | Premier Eye Specialists Pllc | Ophthalmology | 1160 S Linden Rd, Bldg. 1 Ste. A, Flint, MI 48532 | 2018-06-15 |
| 1346438199 | Eye Care Specialists of Michigan, Pllc | Ophthalmology | 2489 Trautner Dr, Saginaw, MI 48604-9596 | 2007-10-05 |
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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.