Shane Matthew Mcgowan (NPI# 1306288816, PAC ID# 2769710425) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1306288816 |
| PAC ID by PECOS | 2769710425 |
| Professional Enrollment ID | I20190820002250 |
| Full Name | Shane Matthew Mcgowan |
| Organization Legal Name | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC |
| Address |
5424 Discovery Park Blvd Williamsburg VA 23188-2862 |
| Phone Number | 7572328764 |
| Gender | M |
| Medical School | STATE UN OF NY, STONY BROOK SCHOOL OF DENTAL MED |
| Graduation Year | 2013 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 2860398526 |
| Number of Group Practice Members | 231 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490041 | BON SECOURS MARY IMMACULATE HOSPITAL |
| 490066 | SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER |
| 390049 | ST LUKE'S HOSPITAL BETHLEHEM |
| 490093 | SENTARA CAREPLEX HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 860 Omni Blvd, Suite 113, Newport News, VA 23606-4430 | 7573270657 | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC |
| 5424 Discovery Park Blvd, Williamsburg, VA 23188-2862 | 7572328764 | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC |
| Organization Legal Name | TIDEWATER PHYSICIANS MULTISPECIALTY GROUP, PC |
| Physicians | 240 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Zelinskas | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 1016 Justis St, Chesapeake, VA 23325-2516 |
| Danae Consuelo Guerra | Physician Assistant | Tidewater Physicians Multispecialty Group, PC | 1100 Volvo Pkwy, Suite 100, Chesapeake, VA 23320-3341 |
| Jennifer Ann Vannoy | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 5399 Old Virginia St, Urbanna, VA 23175-2179 |
| Trina S Williams | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 11751 Rock Landing Dr, Suite 1, Newport News, VA 23606-4233 |
| Stephanie Barnes | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 222 Grafton Dr, Grafton, VA 23692-2152 |
| Latoya Shant'e Kearney | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 1405 Kiln Creek Pkwy K, Newport News, VA 23602-9700 |
| Laurie Harris | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 2117 Hartford Rd, Hampton, VA 23666-2408 |
| Jeffrey Harris | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 307 Cook Rd, Yorktown, VA 23690-9640 |
| Pamala Suter | Registered Dietitian Or Nutrition Professional | Tidewater Physicians Multispecialty Group, PC | 132 Professional Cir, Williamsburg, VA 23185-3374 |
| David Deeley | Family Medicine | Tidewater Physicians Multispecialty Group, PC | 12655 Warwick Blvd A, Newport News, VA 23606-2501 |
| Street Address |
5424 DISCOVERY PARK BLVD |
| City | WILLIAMSBURG |
| State | VA |
| Zip | 23188-2862 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Conceicao Berkowitz | Certified Registered Nurse Anesthetist (crna) | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 101, Williamsburg, VA 23188-2862 |
| Kathy Green | Nurse Practitioner | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 102, Williamsburg, VA 23188-2862 |
| Richard J Hartle | Gastroenterology | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 203, Williamsburg, VA 23188-2862 |
| Kerry A Bate | Occupational Therapy | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 101, Williamsburg, VA 23188-2862 |
| Jessica Kindall Hollowell | Physical Therapy | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 101, Williamsburg, VA 23188-2862 |
| John V Nixon | Cardiovascular Disease (cardiology) | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 203, Williamsburg, VA 23188-2862 |
| Michelle Janeen Arrington | Physical Therapy | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 101, Williamsburg, VA 23188-2862 |
| Stephen Cummings | Orthopedic Surgery | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 203, Williamsburg, VA 23188-2862 |
| Ifeanyichukwu Ani | Urology | Tidewater Physicians Multispecialty Group, PC | 5424 Discovery Park Blvd, Suite 203, Williamsburg, VA 23188-2862 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tina M D'amico | Clinical Social Worker | 151 Kristiansand Dr, 104a, Williamsburg, VA 23188-1013 | |
| Earl W Flora | Psychologist, Clinical | 3305 Poplar Creek Ln, Williamsburg, VA 23188-1058 | |
| Artie Wilding | Chiropractic | 129 Devon Rd, Williamsburg, VA 23188-1541 | |
| Krista M Pine | Psychiatry | Diamond Health Group Inc | 5483 Mooretown Rd, Williamsburg, VA 23188-2108 |
| Matthew Joseph Jaeger | Family Medicine | 5483 Mooretown Rd, Williamsburg, VA 23188-2108 | |
| Hasmukh A Vyas | Psychiatry | Diamond Health Group Inc | 5483 Mooretown Rd, Williamsburg, VA 23188-2108 |
| Norriece Liana Gibson | Geriatric Psychiatry | Diamond Health Group Inc | 5483 Mooretown Rd, Williamsburg, VA 23188-2108 |
| Margaret A Loew-cooney | Clinical Social Worker | Diamond Health Group Inc | 5483 Mooretown Rd, Williamsburg, VA 23188-2108 |
| David R Barley | Optometry | 731 E Rochambeau Dr, Williamsburg, VA 23188-2187 | |
| Dennis Gesualdi | Chiropractic | 3204 Ironbound Rd, Suite A, Williamsburg, VA 23188-2410 | |
| Find all physicians in zip 23188 | |||
| City | WILLIAMSBURG |
| Zip Code | 23188 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | WILLIAMSBURG + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Shane Matthew Mcgowan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.