Individual
ABIGAIL PARK LEE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8301 OLD COURTHOUSE RD, VIENNA, VA 22182-3804
(703) 442-0300
(703) 442-0337
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008855
VA
Other
Enumeration date
06/14/2022
Last updated
04/17/2026
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