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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

EVERETT LEE SHAW, PA-C

Active Sole Proprietor

EVERETT LEE SHAW, PA-C is a Physician Assistant healthcare provider located in DECATUR, Illinois. NPI 1437444163 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · DECATUR, IL

Registration Details

NPI Number
1437444163
Provider Type
Individual
Gender
Male
NPI Issued
Jun 10, 2011 (15.14609175552 yrs)
Last Updated
Jan 17, 2023
License
085.004037 (IL)
Sole Proprietor
Yes

Practice Information

Address
4775 E MARYLAND ST
DECATUR, IL, 625218820
Browse IL providers · Browse ZIP 62521
Phone
2178643737
Fax
2178643468
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in DECATUR, IL

Name Credential NPI
WAYNE ALLEN MATHEWS PAC 1891786943
EMILYE JESSICA GRANT PHYSICIAN ASSISTANT 1396721189
MR. BRIAN P JACQUOT P.A.-C 1053369546
JAMES V WRIGHT PA-C 1497774095
AMANDA C SHILS P.A. 1740399880
JENNIFER R SUNDERLAND PA-C 1659475655
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.