Individual provider · Type 1 NPI

Trent E. Shaw, PA-C

Medical Physician Assistant · Rexburg, ID

NPI number 1366488926 Active

Practice location

72 E Main St
Rexburg, ID 83440-1926

Call (208) 359-1770 Map

Fax (208) 359-1780

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA-308 (ID)
Physician Assistant 363A00000XPA-308 (ID)

Medical Physician Assistant: Definition to come...

4 other providers at this address

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About NPI 1366488926

Trent E. Shaw, PA-C's National Provider Identifier is 1366488926, issued on Jun 21, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Rexburg, ID. The record was last updated on Sep 30, 2011.