Individual
MR. SHAUN TIMOTHY BROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5175
(401) 444-8874
Mailing address
781 AVENT FERRY RD STE 102, HOLLY SPRINGS, NC 27540-7776
(919) 567-6120
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02084
NC
363A00000X
Physician Assistant
PA00703
RI
363AM0700X
Medical Physician Assistant
0010-02084
NC
Other
Enumeration date
10/22/2009
Last updated
08/07/2021
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