Most Relevant Information
Provider Data
| NPI Number: | 1003802943 |
| Provider Name: | MICHAEL DUDLEY SHAW MPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 01331 |
Most Important Dates
| Enumeration Date: | 09/26/2005 |
| Last Updated: | 01/26/2010 |
Provider Practice Location
2138 MENDON RD
#302
CUMBERLAND
RI
028643834
Practice Location Phone/Fax
| Phone: | 4013340218 |
| Fax: | 4013349531 |
Provider Mailing Location
725 RESERVOIR AVE
#101
CRANSTON
RI
029104448
Provider Mailing Phone/Fax
| Phone: | 4019443800 |
| Fax: | 4019441342 |