MEDICARE: SHAWNPO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0010X	Sports Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1003603622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAWNPO LLC

Provider Business Mailing Address
First Line	:	846 WILLIAMSBURG BLVD
Second Line	:
City	:	DOWNINGTOWN
State	:	PA
Zip	:	19335-4127
Country	:	US
Telephone Number	:	610-207-3959
Fax Number	:

Provider Business Practice Location Address
First Line	:	846 WILLIAMSBURG BLVD
Second Line	:
City	:	DOWNINGTOWN
State	:	PA
Zip	:	19335-4127
Country	:	US
Telephone Number	:	610-207-3959
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHAWN POTTEIGER
Credential	:	DO
Telephone Number	:	610-207-3959

Provider Enumeration Date	:	04/24/2025
Last Update Date	:	03/05/2026

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Directions to “SHAWNPO LLC ” Practice Location

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