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Contact Information

STACIE R SHAW, PAC
106 S SCHOOL ROAD
DAGGETT, MI49821
 Phone: 906-753-2155
 Fax: 906-753-2716
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for STACIE R SHAW · (Female)

NPI # 1689784837
Status Active
Credentials PAC
Entity Individual
Enumeration date 08/30/2006
Last updated 01/05/2026 - About 5 months ago
Sole proprietor 1 No
Identifiers
  • MI License # 5601005068
  • WI License # 1117
  • WI Medicaid 42982000
  • Other 1031550 NATIONAL COMMISSION ON CERTIFIED PHYSICIANS ASSISTANTS
  • MI Other 0N41200012 MICHIGAN MEDICARE
Hospital affiliation(s)
  • BAY AREA MED CTR - (Acute Care)
    3100 SHORE DRIVE
    MARINETTE, WI 54143
  • BELLIN MEMORIAL HSPTL - (Acute Care)
    744 S WEBSTER AVE
    GREEN BAY, WI 54305
  • ST FRANCIS HOSPITAL - (Critical Access)
    3401 LUDINGTON ST
    ESCANABA, MI 49829
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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