Provider Demographics
NPI:1336484898
Name:GUNTER, SHAWNA MICHELL (SA-C)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:MICHELL
Last Name:GUNTER
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 LUBRANO DR STE L101
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7568
Mailing Address - Country:US
Mailing Address - Phone:410-224-8383
Mailing Address - Fax:410-626-1698
Practice Address - Street 1:129 LUBRANO DR STE L101
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7568
Practice Address - Country:US
Practice Address - Phone:410-224-8383
Practice Address - Fax:410-626-1698
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant