Individual provider · Type 1 NPI

Marc R. Shaw, PA

Medical Physician Assistant · Columbus, GA

NPI number 1477752863 Active

Practice location

2122 Manchester Expressway
Columbus, GA 31904

Fax (706) 596-4226

Mailing address

PO Box 8147
Columbus, GA 31908-8147

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X5119 (GA)
Medical Physician Assistant Primary 363AM0700X5119 (GA)

Medical Physician Assistant: Definition to come...

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About NPI 1477752863

Marc R. Shaw, PA's National Provider Identifier is 1477752863, issued on Jul 16, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Columbus, GA. The record was last updated on Apr 30, 2026.