Shaw, Marc R
Shaw, Marc R is an individual health care provider with primary practice located at 2122 Manchester Expressway , Columbus GA 31904. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Shaw, Marc R can be contacted via phone (706) 320-2773.Contact Information
Primary practice address
2122 Manchester Expressway
Columbus GA 31904
Phone: (706) 320-2773
Fax: (706) 596-4226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 005119 | Georgia |
Profile Details
| NPI number | 1477752863 |
|---|---|
| LBN Legal business name | Shaw, Marc R |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 16th, 2007 |
| Last updated | Jul 30th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477752863 | NPPES |
| Georgia | MEDICAID | 353912753 | |
| Georgia | MEDICAID | 126321 |
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