Healthcare Provider Details

I. General information

NPI: 1326014127
Provider Name (Legal Business Name): SHAWN F KANE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MANNING DR CB7595
CHAPEL HILL NC
27599-7595
US

IV. Provider business mailing address

303 LAUREL AVE
CARRBORO NC
27510-2213
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-0210
  • Fax: 919-966-6126
Mailing address:
  • Phone: 910-992-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number9600819
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: