Healthcare Provider Details

I. General information

NPI: 1437108628
Provider Name (Legal Business Name): SHAWN MICHAEL HOWERTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 W NC HIGHWAY 24
ROSEBORO NC
28382-8684
US

IV. Provider business mailing address

304 W NC HIGHWAY 24
ROSEBORO NC
28382-8684
US

V. Phone/Fax

Practice location:
  • Phone: 910-525-5848
  • Fax: 910-525-3838
Mailing address:
  • Phone: 910-525-5848
  • Fax: 910-525-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.084481
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2005-00915
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: