Individual
SHASTA R CORUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
300 FOXCROFT AVE STE 307, MARTINSBURG, WV 25401-5341
(703) 283-7002
(304) 596-2392
Mailing address
300 FOXCROFT AVE STE 307, MARTINSBURG, WV 25401-5341
(703) 283-7002
(304) 596-2392
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/13/2022
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