NPI 1013452002

Ethan T Shaver, PA

Practitioner Physician Assistant Green Bay, WI

Practice location

Address: 1110 Kepler Dr, Green Bay, WI 54311-8306
Phone: (920) 288-5555
Fax: (920) 288-5550
Mailing address: 1035 Kepler Dr, Green Bay, WI 54311-8320

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

Other Physician Assistant providers in Wisconsin →

Registry record

NPI: 1013452002
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Dec 2016
Record last updated: 19 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.