Thomas, Shawn Wayne

Thomas, Shawn Wayne is an individual health care provider with primary practice located at 311 N Clyde Morris Blvd Ste 360 , Daytona Beach FL 32114-2757. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Thomas, Shawn Wayne can be contacted via phone (386) 254-4199.

Contact Information

Primary practice address
311 N Clyde Morris Blvd Ste 360 Daytona Beach FL 32114-2757
Phone: (386) 254-4199
Fax: (386) 947-4680
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 0S013305 Pennsylvania
Allopathic & Osteopathic Physicians / Urology 208800000X OS10348 Florida
Allopathic & Osteopathic Physicians / Urology 208800000X 2603 West Virginia

Profile Details

NPI number 1043416506
LBN Legal business name Thomas, Shawn Wayne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2007
Last updated Jan 27th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043416506 NPPES
West Virginia MEDICAID 3810024050
West Virginia MEDICAID 000282900

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