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1376570689
SHAWN EDMUND VAN WALLENDAEL
CHARLOTTE, NC
NPI
1376570689
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 103076)
Enumeration Date
2006-06-26
Last Update Date
2024-07-15
Business Address
SHAWN EDMUND VAN WALLENDAEL PA
10648 PARK RD
CHARLOTTE, NC 28210-8407
Phone number: 704-355-9330
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Mailing Address
SHAWN EDMUND VAN WALLENDAEL PA
PO BOX 19305
CHARLOTTE, NC 28219-9305
Phone number:
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