Individual
SHAWN BELL MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 MEDICAL DR STE 705, LAGRANGE, GA 30240-4130
(706) 803-7960
Mailing address
300 MEDICAL DR STE 705, LAGRANGE, GA 30240-4130
(706) 803-7960
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
079724
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
755879
—
AZ
01
—
AZ0728210
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
03/08/2007
Last updated
04/01/2024
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