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General NPI Number Information
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NPI Number | 1972602886
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Entity Type | Individual
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Provider Name | SHAWNA LYN BULL PHELPS MD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 02/27/2015
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Provider Practice Location Address
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Address Line | 20 MEDICAL PARK DR
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City | ASHEVILLE
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State | NC
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Zip | 28803-2493
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Country | US
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Telephone | 828-274-7502
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Fax | 828-271-6599
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 2013-01236
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 2013-01236
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License Number State | NC
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