Most Relevant Information
Provider Data
| NPI Number: | 1003575622 |
| Provider Name: | SHAUN LAMONT WARREN NEMT |
| Entity Type: | Individual |
| Taxonomy Code: | 172A00000X |
| Specialty: | Driver |
| License Number: | T60335142 |
Most Important Dates
| Enumeration Date: | 12/10/2021 |
| Last Updated: | 12/10/2021 |
Provider Practice Location
501 BULKELEY PL APT 1
NEWPORT NEWS
VA
236014124
Practice Location Phone/Fax
| Phone: | 7579039193 |
| Fax: |
Provider Mailing Location
501 BULKELEY PL APT 1
NEWPORT NEWS
VA
236014124
Provider Mailing Phone/Fax
| Phone: | 7579039193 |
| Fax: |