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Individual

BRANDON P SHAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 838-8710
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 828-8710
(334) 395-4110

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN181110
GA

Other

Enumeration date
02/08/2012
Last updated
02/09/2012
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