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Everett Shaw, PA-C

NPI 1437444163 · on the registry since 2011 · sole proprietor

Practice

Address
4775 E Maryland St
Decatur, IL 62521
Phone
(217) 864-3737
Fax
(217) 864-3468
Clinicians at this address
8

Registry record

Primary taxonomy
363A00000X
363A00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-01-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois