Individual
DARRELL LEVERN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CST/CSFA
Contact information
Practice address
8116 ARLINGTON BLVD STE 183, FALLS CHURCH, VA 22042-1002
(703) 659-4557
(703) 205-9010
Mailing address
8116 ARLINGTON BLVD STE 183, FALLS CHURCH, VA 22042-1002
(703) 659-4557
(703) 205-9010
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA0189
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170342
NBSTSA
—
01
—
SA0189
DEPT OF HEALTH BOARD OF MEDICINE
DC
Enumeration date
05/30/2017
Last updated
05/30/2017
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