Individual
ROBERT EARL SHONK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
410 DARLING AVE, ANESTHESIA DEPT, WAYCROSS, GA 31501-5246
(912) 338-6511
(912) 338-6512
Mailing address
PO BOX 18824, GREENSBORO, NC 27419-8824
(336) 553-1659
(336) 553-3994
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
005166
GA
367H00000X
Anesthesiologist Assistant
1564
GA
367H00000X
Anesthesiologist Assistant
Primary
67.000131
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
655272915A
—
GA
Enumeration date
05/11/2007
Last updated
03/04/2022
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