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Individual

MR. SHEA TRYON WHITTAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
200 W WOODCROFT PKWY APT 37B, DURHAM, NC 27713-8082
(919) 996-8674

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
08/02/2019
Last updated
08/02/2019
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