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1013452002
ETHAN T SHAVER
GREEN BAY, WI
NPI
1013452002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2016-12-29
Last Update Date
2024-04-10
Business Address
ETHAN T SHAVER PA
2845 GREENBRIER RD
GREEN BAY, WI 54311-6519
Phone number: 920-288-5555
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Mailing Address
ETHAN T SHAVER PA
1035 KEPLER DR
GREEN BAY, WI 54311-8320
Phone number:
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