Provider Demographics
NPI:1699905026
Name:SHAW, MICHAEL ANDREW (PAC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANDREW
Last Name:SHAW
Suffix:
Gender:M
Credentials:PAC
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Mailing Address - Street 1:2800 BUFORD DR STE 410
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-5107
Mailing Address - Country:US
Mailing Address - Phone:770-292-6500
Mailing Address - Fax:770-292-6535
Practice Address - Street 1:2800 BUFORD DR STE 410
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-5107
Practice Address - Country:US
Practice Address - Phone:770-292-6500
Practice Address - Fax:770-292-6535
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2025-08-23
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Provider Licenses
StateLicense IDTaxonomies
GA13075363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant