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Individual

DOUGLAS SHEARER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, BSN,BLS

Contact information

Practice address
20 KENT ST, PHOENIX, NY 13135-2230
(315) 560-3367
Mailing address
20 KENT ST, PHOENIX, NY 13135-2230
(315) 560-3367

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
593393
NY

Other

Enumeration date
08/20/2021
Last updated
08/20/2021
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