MARC R SHAW PA NPI 1477752863

NPI Information

NPI: 1477752863
Provider Name: MARC R SHAW, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
2122 MANCHESTER EXPRESSWAY
COLUMBUS, GA
ZIP 31904
Phone: (706) 320-2773
Get Directions

Marc R Shaw, PA is a medical physician assistant in Columbus, GA with 17 years of experience. Marc R Shaw, PA NPI is 1477752863. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2122 MANCHESTER EXPRESSWAY
COLUMBUS, GA
ZIP 31904
Phone: (706) 320-2773
Fax: (706) 596-4226

The NPI 1477752863 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/16/2007 and was last updated on 7/30/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	005119	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	202I979686	MEDICARE PIN	GEORGIA
2	126321	MEDICAID	ALABAMA
3	353912753	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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