Ethan T Shaver, PA

NPI #1013452002 in Green Bay, Wisconsin

Provider Information

NPI Number: 1013452002
Entity Type: Individual
Name: Ethan T Shaver, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Dec 29, 2016
Last Updated: Apr 10, 2024

Practice Location

Address: 2845 GREENBRIER RD
City: Green Bay
State: Wisconsin
ZIP Code: 54311-6519
Phone: (920) 288-5555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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