Provider Demographics
NPI:1942440474
Name:ECK, SHAWN P (PA-C)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:P
Last Name:ECK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:5 NEPONSET ST FL STREET2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-368-5532
Mailing Address - Fax:508-721-9106
Practice Address - Street 1:35 MILLBURY ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-3203
Practice Address - Country:US
Practice Address - Phone:508-721-1180
Practice Address - Fax:508-721-9106
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2019-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAPA3738363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant