Provider Demographics
NPI:1225246903
Name:CORWIN, SHAWN M (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:M
Last Name:CORWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 LAKE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3801
Mailing Address - Country:US
Mailing Address - Phone:972-899-6666
Mailing Address - Fax:
Practice Address - Street 1:995 N WALNUT CREEK DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-1503
Practice Address - Country:US
Practice Address - Phone:817-453-6980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55789207P00000X
MI4301086081207P00000X
TXM9227207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00860249OtherRAILROAD
TX195007308Medicaid
TX195007308Medicaid