Individual provider · Type 1 NPI

Stacy Shane Shaw

Surgical Physician Assistant · Pittsfield, MA

NPI number 1770185225 Active

Practice location

725 North St
Pittsfield, MA 01201-4109

Mailing address

3814 SE 98th Ave
Portland, OR 97266-2502

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1770185225

Stacy Shane Shaw's National Provider Identifier is 1770185225, issued on Nov 10, 2020. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Pittsfield, MA. The record was last updated on Nov 10, 2020.