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General NPI Number Information
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NPI Number | 1205240181
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Entity Type | Individual
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Provider Name | SHAWN FELLOWS PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 322 LAKE AVE
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City | ROCHESTER
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State | NY
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Zip | 14608-1162
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Country | US
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Telephone | 585-721-8032
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Fax |
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Provider Business Mailing Address
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Address Line | 3690 EAST AVE
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City | ROCHESTER
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State | NY
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Zip | 14618-3537
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Country | US
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Telephone | 585-721-8032
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | A1-0004064
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RPH.03129582-1
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RP447622
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 059191
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License Number State | NY
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