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General NPI Number Information
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NPI Number | 1801005855
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Entity Type | Individual
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Provider Name | SHAWN M. JOBE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 1200 E MICHIGAN AVE STE 145
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City | LANSING
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State | MI
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Zip | 48912-1897
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Country | US
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Telephone | 517-364-5440
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Fax | 517-364-5409
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Provider Business Mailing Address
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Address Line | 804 SERVICE RD STE A109B
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City | EAST LANSING
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State | MI
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Zip | 48824-7015
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Country | US
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Telephone | 517-364-5440
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Fax | 517-364-5409
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 61019-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 36649
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 4301503602
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License Number State | MI
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