Individual
SHAUN ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 SANSBERRY RD, CHARLOTTE, NC 28262-4937
(302) 897-2404
Mailing address
1601 SANSBERRY RD, CHARLOTTE, NC 28262-4937
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1172511
—
DE
Enumeration date
12/04/2019
Last updated
12/04/2019
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