Provider Demographics
NPI:1407912223
Name:MEI, SHAWN XUN (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:XUN
Last Name:MEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15164 DEDEAUX RD
Mailing Address - Street 2:STE B
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-3124
Mailing Address - Country:US
Mailing Address - Phone:228-284-1642
Mailing Address - Fax:228-284-1643
Practice Address - Street 1:15164 DEDEAUX RD
Practice Address - Street 2:STE B
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3124
Practice Address - Country:US
Practice Address - Phone:228-284-1642
Practice Address - Fax:228-284-1643
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01059275A207L00000X
GA052181207L00000X
OH35082500M207L00000X
CAA87740207L00000X
VA0101233699207L00000X
MSPC-00065207LP2900X
MS18456208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSYJ8HMedicare UPIN