Provider Demographics
NPI:1801683446
Name:DUJANOVIC, SHAWN
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:DUJANOVIC
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:
Other - Last Name:MCNULTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22560 ROY CROY RD
Mailing Address - Street 2:
Mailing Address - City:SENECAVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43780-9681
Mailing Address - Country:US
Mailing Address - Phone:507-202-1313
Mailing Address - Fax:
Practice Address - Street 1:4040 STONE RIDGE RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-0501
Practice Address - Country:US
Practice Address - Phone:614-726-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator