Provider Demographics
NPI:1669789947
Name:COMBS, SHAWN CHRISTIAN (CSA)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:CHRISTIAN
Last Name:COMBS
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13732 MARILYN CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-4410
Mailing Address - Country:US
Mailing Address - Phone:571-297-5861
Mailing Address - Fax:866-577-7903
Practice Address - Street 1:13732 MARILYN CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-4410
Practice Address - Country:US
Practice Address - Phone:571-297-5861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant