Provider Demographics
NPI:1184796484
Name:SHAW, STEVEN WAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WAYNE
Last Name:SHAW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-2216
Mailing Address - Country:US
Mailing Address - Phone:860-225-7429
Mailing Address - Fax:860-826-4762
Practice Address - Street 1:136 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1315
Practice Address - Country:US
Practice Address - Phone:860-225-7429
Practice Address - Fax:860-826-4765
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2995111NX0800X
NY4095111NX0800X
CT610111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic