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General NPI Number Information
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NPI Number | 1316287618
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Entity Type | Individual
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Provider Name | SHAWN ENO C.PED.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2013
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Last Update Date | 02/22/2013
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Provider Practice Location Address
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Address Line | 222 17TH AVENUE
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City | IDAHO SPRINGS
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State | CO
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Zip | 80452
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Country | US
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Telephone | 303-567-2271
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Fax | 720-328-4430
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Provider Business Mailing Address
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Address Line | 222 17TH AVENUE
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City | IDAHO SPRINGS
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State | CO
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Zip | 80452-0484
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Country | US
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Telephone | 303-567-2271
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Fax | 720-328-4430
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | CPED0697
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License Number State |
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