Provider Demographics
NPI:1629160197
Name:LAFERRIERE, SHAWN LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:LEE
Last Name:LAFERRIERE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4701 TURNBERRY LN UNIT 20
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-8062
Mailing Address - Country:US
Mailing Address - Phone:706-563-2621
Mailing Address - Fax:
Practice Address - Street 1:163 VAN BUREN RD
Practice Address - Street 2:STE 1
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-3567
Practice Address - Country:US
Practice Address - Phone:207-498-1164
Practice Address - Fax:207-498-1149
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-1114272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology