Provider Demographics
NPI:1245840529
Name:SHEARS, DANIEL (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:SHEARS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 HARRISON ST # 354
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4463
Mailing Address - Country:US
Mailing Address - Phone:919-370-6251
Mailing Address - Fax:
Practice Address - Street 1:559 RIVER HWY
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6829
Practice Address - Country:US
Practice Address - Phone:704-663-3438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist