Individual
SHAWN AUSTIN HAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
116 MOORE ALLEN ST, DUDLEY, NC 28333-5329
(919) 750-9900
Mailing address
116 MOORE ALLEN ST, DUDLEY, NC 28333-5329
(919) 750-9900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1057107754
HUMANA MILITARY
NC
Enumeration date
06/06/2022
Last updated
06/06/2022
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