Provider Demographics
NPI:1841967031
Name:TREADWAY, SHAWN (RT (R) (CT))
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:TREADWAY
Suffix:
Gender:F
Credentials:RT (R) (CT)
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RT (R) (CT)
Mailing Address - Street 1:12 TWELVE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-0034
Mailing Address - Country:US
Mailing Address - Phone:828-779-8936
Mailing Address - Fax:
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2576
Practice Address - Country:US
Practice Address - Phone:828-298-7911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2545422085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging