Individual
CHARLES SHANE DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4130 OLEANDER DR STE 100, WILMINGTON, NC 28403-6844
(910) 338-3494
(910) 338-0860
Mailing address
PO BOX 52411, PHOENIX, AZ 85072-2411
(919) 785-3400
(919) 783-7778
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
2023-01908
NC
208100000X
Physical Medicine & Rehabilitation Physician
2023-01908
NC
208100000X
Physical Medicine & Rehabilitation Physician
A94985
CA
208VP0000X
Pain Medicine Physician
2023-01908
NC
208VP0014X
Interventional Pain Medicine Physician
Primary
2023-01908
NC
Other
Enumeration date
11/13/2007
Last updated
12/04/2025
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