Individual
MICHAEL SHANE EXUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(229) 244-6852
Mailing address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(229) 244-6852
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN210620
GA
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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