Provider Demographics
NPI:1477885937
Name:SEUFERT, SHANNON COOK (PHARMD)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:COOK
Last Name:SEUFERT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 WRIGHTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-7056
Mailing Address - Country:US
Mailing Address - Phone:910-791-2346
Mailing Address - Fax:910-791-6885
Practice Address - Street 1:5220 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7056
Practice Address - Country:US
Practice Address - Phone:910-791-2346
Practice Address - Fax:910-791-6885
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist