Individual
SHANE COLIN CIUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 MORRIS STREET, CHARLESTON, WV 25301
(304) 388-5432
Mailing address
400 ASSOCIATION DRIVE, SUITE 102, CHARLESTON, WV 25311
(304) 760-7536
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/08/2023
Last updated
10/22/2025
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