Individual
SHANAR H LOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1001 WIDEWATERS PKWY, KNIGHTDALE, NC 27545-6102
(919) 861-2020
(919) 277-0854
Mailing address
7100 SIX FORKS RD, SUITE 301, RALEIGH, NC 27615-6156
(919) 847-0187
(919) 676-2231
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2205
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0932U
NORTH CAROLINA BCBS
NC
05
—
5915885
—
NC
01
—
P01211057
RAILROAD MEDICARE
—
Enumeration date
08/24/2010
Last updated
10/15/2013
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