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General NPI Number Information
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NPI Number | 1548365364
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Entity Type | Individual
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Provider Name | LONNIE NEWELL SHULL JR. MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 401 MULBERRY ST SW STE 101
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City | LENOIR
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State | NC
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Zip | 28645-1648
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Country | US
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Telephone | 828-758-5501
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Fax | 828-758-0080
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Provider Business Mailing Address
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Address Line | PO BOX 1648 401 MULBERRY ST SW STE 101
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City | LENOIR
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State | NC
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Zip | 28645-1648
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Country | US
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Telephone | 828-758-5501
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Fax | 828-758-0080
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 19190
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License Number State | NC
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