Individual
MR. SHANNON SHUMATE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2000 NEUSE BLVD, NEW BERN, NC 28560-3449
(252) 634-6504
Mailing address
5901 PEACHTREE DUNWOODY RD NE STE C350, ATLANTA, GA 30328-7159
(678) 441-8539
(678) 441-8639
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60664247
WA
363AM0700X
Medical Physician Assistant
Primary
0010-03963
NC
Other
Enumeration date
01/07/2013
Last updated
01/03/2023
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