Provider Demographics
NPI:1851783526
Name:SHEMWELL, BYRON
Entity Type:Individual
Prefix:
First Name:BYRON
Middle Name:
Last Name:SHEMWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 UNIVERSITY BLVD N APT 903
Mailing Address - Street 2:JACKSONVILLE
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2362
Mailing Address - Country:US
Mailing Address - Phone:904-428-6434
Mailing Address - Fax:
Practice Address - Street 1:3500 UNIVERSITY BLVD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-2302
Practice Address - Country:US
Practice Address - Phone:904-428-6434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor