Organization
SHADOW EMERGENCY PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN VAUGHN (AUTHORIZED OFFICIAL)
(404) 450-4684
Entity
Organization
Contact information
Practice address
6625 N 5TH ST, NORTH LAS VEGAS, NV 89084-1341
(702) 388-4000
Mailing address
PO BOX 13917, PHILADELPHIA, PA 19101-3917
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
10/12/2023
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