Healthcare Provider Details

I. General information

NPI: 1417676735
Provider Name (Legal Business Name): SHULUN GU PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 W MAIN ST
DURHAM NC
27701-3604
US

IV. Provider business mailing address

114 W MAIN ST
DURHAM NC
27701-3604
US

V. Phone/Fax

Practice location:
  • Phone: 196-888-9789
  • Fax:
Mailing address:
  • Phone: 919-688-8978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31327
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: