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Individual

MR. CHARLES T SHINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 258-6511
(937) 267-3998
Mailing address
200 E RAHN RD, DAYTON, OH 45429-5424
(937) 434-5456

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN217919/NA01171
OH

Other

Enumeration date
08/08/2006
Last updated
07/08/2007
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