Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derrick Chase Shaw

Individual provider Independent Duty Medical Technicians · NPI 1336865146

Derrick Chase Shaw is an Independent Duty Medical Technicians in Lusby, Maryland. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

1185 Cordova Dr
Lusby, MD 20657-4538
Phone: (402) 705-3896
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Medical Technicians (primary) Taxonomy 1710I1003X

Record details

NPI number1336865146
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 13, 2022
Last updated in NPPESApril 4, 2023
Certification dateApril 4, 2023
Mailing address1185 Cordova Dr, Lusby, MD 20657-4538