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Individual

DR. MICHAEL W SHOTWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
684 SIXES RD, SUITE 225, HOLLY SPRINGS, GA 30115-8721
(770) 704-6101
Mailing address
19105 N US HIGHWAY 41, STE 300, LUTZ, FL 33549-4206
(770) 704-6101

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
053168
GA
208600000X
Surgery Physician
ME127994
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
163054290A
GA
Enumeration date
02/13/2006
Last updated
06/22/2016
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