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Individual

SHANE C PIERCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2180 HARARE PL, DULLES, VA 20189-2180
(202) 663-2453
Mailing address
2401 E STREET NW, M/MED/QI SA-1, WASHINGTON DC, DC 20522-0102
(202) 663-2453

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005093
WA

Other

Enumeration date
10/26/2006
Last updated
07/08/2007
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