Dale Russell Shaw (NPI# 1093709495, PAC ID# 1951328590) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1093709495 |
| PAC ID by PECOS | 1951328590 |
| Professional Enrollment ID | I20140728002464 |
| Full Name | Dale Russell Shaw |
| Organization Legal Name | CHARLOTTE RADIOLOGY PA |
| Address |
175 Amendment Ave Rock Hill SC 29732-3042 |
| Phone Number | 7043621945 |
| Gender | M |
| Credential | MD |
| Medical School | DUKE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1973 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 4587577390 |
| Number of Group Practice Members | 139 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340166 | CAROLINAS MED CTR-UNIVERSITY |
| 340084 | CAROLINAS HEALTH CARE SYSTEM ANSON |
| Address | Phone | Organization |
|---|---|---|
| 1025 Morehead Medical Dr, Charlotte, NC 28204-2973 | CHARLOTTE RADIOLOGY PA | |
| 1025 Morehead Medical Dr, Suite 150, Charlotte, NC 28204-2973 | CHARLOTTE RADIOLOGY PA | |
| 3816 Latrobe Dr, Charlotte, NC 28211-1167 | 7049095960 | CHARLOTTE RADIOLOGY PA |
| 4525 Cameron Valley Pkwy, Charlotte, NC 28211-4370 | 7043621945 | CHARLOTTE RADIOLOGY PA |
| 4525 Cameron Valley Pkwy, Suite 1000, Charlotte, NC 28211-4370 | 7043621945 | CHARLOTTE RADIOLOGY PA |
| 724 Aubrey Bell Dr, Matthews, NC 28105-5055 | 7043625391 | CHARLOTTE RADIOLOGY PA |
| 1656 Riverchase Blvd, Rock Hill, SC 29732-0270 | 8033279934 | CHARLOTTE RADIOLOGY PA |
| 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 | 8033279934 | CHARLOTTE RADIOLOGY PA |
| 175 Amendment Ave, Rock Hill, SC 29732-3042 | 7043621945 | CHARLOTTE RADIOLOGY PA |
| 175 Amendment Ave, Suite 104, Rock Hill, SC 29732-3042 | 7043621945 | CHARLOTTE RADIOLOGY PA |
| Organization Legal Name | CHARLOTTE RADIOLOGY PA |
| Physicians | 141 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew Bennett | Diagnostic Radiology | Charlotte Radiology Pa | 1045 Negateway Ne Ct, Concord, NC 28025-2440 |
| Adrienne C Bean | Diagnostic Radiology | Charlotte Radiology Pa | 1090 Nw Gateway Ct, Suite 202, Concord, NC 28025-2414 |
| Marc Angelo Mancuso | Diagnostic Radiology | Charlotte Radiology Pa | 1802 E Main St, Lincolnton, NC 28092-3915 |
| Brian Adrian Howard | Diagnostic Radiology | Charlotte Radiology Pa | 3816 Latrobe Dr, Charlotte, NC 28211-1167 |
| Gary Joseph Defilipp | Diagnostic Radiology | Charlotte Radiology Pa | 7666 Charlotte Hwy 120, Indian Land, SC 29707-7003 |
| Ole Sami Aassar | Diagnostic Radiology | Charlotte Radiology Pa | 200 Glendale Dr W, Wilson, NC 27893-2772 |
| Pamela Sutton Oravetz | Physician Assistant | Charlotte Radiology Pa | 920 Church St N, Concord, NC 28025-2927 |
| Michael V. Varricchio Jr. | Physician Assistant | Charlotte Radiology Pa | 920 Church St N, Concord, NC 28025-2927 |
| Chelsea N Hanne | Physician Assistant | Charlotte Radiology Pa | 920 Church St N, Concord, NC 28025-2927 |
| Robert J Hosker | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| Street Address |
175 AMENDMENT AVE |
| City | ROCK HILL |
| State | SC |
| Zip | 29732-3042 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles Scott Mclanahan | Neurosurgery | Carolina Neurosurgery and Spine Associates Pa | 175 Amendment Ave, Rock Hill, SC 29732-3039 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Carl Cedarholm | Interventional Cardiology | Carolinas Physicians Network Inc | 1656 Riverchase Blvd, Suite 2500, Rock Hill, SC 29732-0269 |
| Crystal Rachelle Vaglia | Nurse Practitioner | Carolinas Physicians Network Inc | 1656 Riverchase Blvd, Suite 2500, Rock Hill, SC 29732-0269 |
| Robert J Hosker | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| Hyonah Kim | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| Nathan Patrick Fergus | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| Rickin Shah | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| Brian Alan Perry | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| Kelly Clifford | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| James Essenberg | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| Richard D Redvanly | Diagnostic Radiology | Charlotte Radiology Pa | 1656 Riverchase Blvd, Suite 1200, Rock Hill, SC 29732-0270 |
| Find all physicians in zip 29732 | |||
| City | ROCK HILL |
| Zip Code | 29732 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | ROCK HILL + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Dale Russell Shaw.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.