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General NPI Number Information
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NPI Number | 1386075471
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Entity Type | Individual
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Provider Name | DAVID SHAWN HANBERRY
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Gender | Male
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Dates
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Enumeration Date | 11/27/2013
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 128 CHURCH RD
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City | POQUOSON
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State | VA
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Zip | 23662-2204
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Country | US
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Telephone | 757-771-9548
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Fax | 757-868-6527
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Provider Business Mailing Address
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Address Line | 128 CHURCH RD
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City | POQUOSON
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State | VA
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Zip | 23662-2204
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Country | US
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Telephone | 757-771-9548
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Fax | 757-868-6527
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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