Individual
MR. SHANE C MORGAN
Active
Individual
MR. SHANE C MORGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00266
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000030809
BC BS OF RHODE ISALND
RI
01
—
201049483
UNITED HEALTH
RI
01
—
409375
BLUE CHIP
RI
05
—
9004028
—
RI
Enumeration date
08/26/2005
Last updated
04/05/2019
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