Provider Demographics
NPI:1710439807
Name:MCGUYRT, SHAWN M (NPC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:M
Last Name:MCGUYRT
Suffix:
Gender:M
Credentials:NPC
Other - Prefix:
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Mailing Address - Street 1:4105 HOLIDAY ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2531
Mailing Address - Country:US
Mailing Address - Phone:330-494-2097
Mailing Address - Fax:330-494-9750
Practice Address - Street 1:12670 CREEKSIDE LN STE 202
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3370
Practice Address - Country:US
Practice Address - Phone:239-482-2663
Practice Address - Fax:239-482-7585
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2020-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020107363L00000X
FLAPRN9486163363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner