Provider Demographics
NPI:1134356876
Name:GUNDER, SHAWN E (PA-C)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:E
Last Name:GUNDER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:811 13TH ST STE 20
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2771
Mailing Address - Country:US
Mailing Address - Phone:706-722-3401
Mailing Address - Fax:706-724-6540
Practice Address - Street 1:811 13TH ST STE 20
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2771
Practice Address - Country:US
Practice Address - Phone:706-722-3401
Practice Address - Fax:706-724-6540
Is Sole Proprietor?:No
Enumeration Date:2009-06-21
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA002919363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical