Individual
SHAWN A MCCLURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
3200 S UNIVERSITY DR, DEPT. OF OMFS, DAVIE, FL 33328-2018
(954) 262-7153
Mailing address
PO BOX 290370, DEPT. OF OMFS, FT LAUDERDALE, FL 33329-0370
(954) 262-4346
(954) 262-2269
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
ME99010
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000935700
—
FL
01
—
AF3407
MEDICARE
FL
Enumeration date
02/15/2007
Last updated
03/28/2017
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