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General NPI Number Information
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NPI Number | 1760464663
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Entity Type | Individual
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Provider Name | SHAWN MICHELLE DALTON-BETHEA MD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 1028 BLAIR ST
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City | THOMASVILLE
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State | NC
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Zip | 27360-4359
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Country | US
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Telephone | 201-654-6397
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Fax | 201-608-9241
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Provider Business Mailing Address
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Address Line | PO BOX 38728
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City | GREENSBORO
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State | NC
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Zip | 27438-8728
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Country | US
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Telephone | 336-501-3796
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Fax | 336-333-5477
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 21959
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD423882
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2007-00213
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License Number State | NC
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