Individual
MR. SHAUN DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4755 OGLETOWN-STANTON RD, NEWARK, DE 19718-0001
(302) 733-1000
Mailing address
1403 N ADAMS ST, WILMINGTON, DE 19806-3207
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C5-0000451
DE
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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