Provider Demographics
NPI:1619498698
Name:SHAW, AMANDA T (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:T
Last Name:SHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6930 CAHABA VALLEY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2673
Mailing Address - Country:US
Mailing Address - Phone:205-783-5207
Mailing Address - Fax:205-783-5210
Practice Address - Street 1:6930 CAHABA VALLEY RD STE 102
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-2673
Practice Address - Country:US
Practice Address - Phone:205-783-5207
Practice Address - Fax:205-783-5210
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2025-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL38006207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program