National Provider Identifier Database

MARC R SHAW, PA – NPI #1477752863
Medical


Contact Information

MARC R SHAW, PA
2122 MANCHESTER EXPRESSWAY
COLUMBUS, GA31904
Phone: 706-320-2773
Fax: 706-596-4226
Website:
Specialty Taxonomy Code
* Medical 363AM0700X
Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for MARC R SHAW

NPI Number 1477752863
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 07/16/2007
Last updated 04/30/2026 - About a month ago
Sole proprietor1 No
Identifiers
  • GA License #: 5119
  • AL Medicaid: 126321
  • GA Medicaid: 353912753
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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