Provider Demographics
NPI:1437108628
Name:HOWERTON, SHAWN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MICHAEL
Last Name:HOWERTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W NC HIGHWAY 24
Mailing Address - Street 2:
Mailing Address - City:ROSEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28382-8684
Mailing Address - Country:US
Mailing Address - Phone:910-525-5848
Mailing Address - Fax:910-525-3838
Practice Address - Street 1:304 W NC HIGHWAY 24
Practice Address - Street 2:
Practice Address - City:ROSEBORO
Practice Address - State:NC
Practice Address - Zip Code:28382-8684
Practice Address - Country:US
Practice Address - Phone:910-525-5848
Practice Address - Fax:910-525-3838
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.084481207Q00000X
NC2005-00915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC183913OtherMEDCOST PREFERRED PIN
NC141R7OtherBLUE CROSS BS PIN
NC5901226Medicaid
NC141R7OtherNC BLUE CROSS BS PIN
NC331724OtherWELLPATH HEALTHCARE PIN
NC4867117OtherCIGNA HEALTHCARE PIN
NC4867117OtherCIGNA HEALTHCARE PIN
NCI38715Medicare UPIN