Healthcare Provider Details

I. General information

NPI: 1730677782
Provider Name (Legal Business Name): SHAWN J WARNER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HAYES AVE
SANDUSKY OH
44870-3323
US

IV. Provider business mailing address

1111 HAYES AVE
SANDUSKY OH
44870-3323
US

V. Phone/Fax

Practice location:
  • Phone: 419-502-2800
  • Fax: 419-502-2821
Mailing address:
  • Phone: 419-502-2800
  • Fax: 419-502-2821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number34.015748
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.015748
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: