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General NPI Number Information
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NPI Number | 1003603622
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Entity Type | Organization
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Legal Business Name | SHAWNPO LLC
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 846 WILLIAMSBURG BLVD
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-4127
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Country | US
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Telephone | 610-207-3959
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Fax |
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Provider Business Mailing Address
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Address Line | 846 WILLIAMSBURG BLVD
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-4127
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Country | US
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Telephone | 610-207-3959
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAWN POTTEIGER
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Credential | DO
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Telephone | 610-207-3959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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