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Individual

MR. SHAUN LAMONT WARREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NEMT

Contact information

Practice address
501 BULKELEY PL APT 1, NEWPORT NEWS, VA 23601-4124
(757) 903-9193
Mailing address
501 BULKELEY PL APT 1, NEWPORT NEWS, VA 23601-4124
(757) 903-9193

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T60335142
VA

Other

Enumeration date
12/10/2021
Last updated
12/10/2021
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