Basic Information
| Provider Information | |||||||||
| NPI: | 1730677782 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WARNER | ||||||||
| FirstName: | SHAWN | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 HAYES AVE | ||||||||
| Address2: | |||||||||
| City: | SANDUSKY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448703323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195022800 | ||||||||
| FaxNumber: | 4195022821 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 HAYES AVE | ||||||||
| Address2: | |||||||||
| City: | SANDUSKY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448703323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195022800 | ||||||||
| FaxNumber: | 4195022821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2018 | ||||||||
| LastUpdateDate: | 05/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 34.015748 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.