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Individual

SHANE TROTTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(317) 555-5555
Mailing address
332 CONGRESS PARK DR, DAYTON, OH 45459-4133

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001867A
IN
363A00000X
Physician Assistant
Primary

Other

Enumeration date
10/16/2013
Last updated
03/25/2026
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