Individual
DR. SHAWNA LYN BULL PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 MEDICAL PARK DR, ASHEVILLE, NC 28803-2493
(828) 274-7502
(828) 271-6599
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
2013-01236
NC
207VX0201X
Gynecologic Oncology Physician
Primary
2013-01236
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171282001
—
TX
05
—
171282003
—
TX
05
—
171282004
—
TX
05
—
1972602886
—
NC
05
—
200215610A
—
OK
01
—
8AQ004
BCBSTX
TX
01
—
P00748698
RAILROAD MEDICARE
TX
01
—
P01267093
RAILROAD MCR
FL
Enumeration date
09/21/2006
Last updated
02/27/2015
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