Provider Demographics
NPI:1134259278
Name:STRICKLAND, SHAWN EDWARD (DMSC, MPAS, PA)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:EDWARD
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:DMSC, MPAS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:ANSTED
Mailing Address - State:WV
Mailing Address - Zip Code:25812
Mailing Address - Country:US
Mailing Address - Phone:304-658-6007
Mailing Address - Fax:304-658-6017
Practice Address - Street 1:101 FLORENCE STREET
Practice Address - Street 2:
Practice Address - City:ANSTED
Practice Address - State:WV
Practice Address - Zip Code:25812
Practice Address - Country:US
Practice Address - Phone:304-658-5100
Practice Address - Fax:304-658-3375
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1233363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1224AMedicare PIN