Provider Demographics
NPI:1881034346
Name:SHAWVER, CAMERON M (DO)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:M
Last Name:SHAWVER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3889
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-3889
Mailing Address - Country:US
Mailing Address - Phone:423-794-5742
Mailing Address - Fax:423-283-9480
Practice Address - Street 1:316 MARKETPLACE DR STE 20
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2596
Practice Address - Country:US
Practice Address - Phone:423-794-5580
Practice Address - Fax:423-232-8561
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4285207Q00000X, 208VP0000X, 208VP0014X
NE1232208VP0014X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine