Shane Izon Datugan

Physician Assistant · Quantico, VA

Individual Active NPI

NPI number 1538817036

Practice location

3259 Catlin Ave
Quantico, VA 22134-5109
Phone
(703) 784-1725

Open in Google Maps

NPI record

NPI
1538817036
Entity type
Individual (Type 1)
Enumeration date
March 14, 2022
Last updated
March 14, 2022
Certified
February 28, 2022
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X — —

Mailing address

4106 Rosewood Drive
Unit 2
Joint Base Andrews, MD 20746

About Shane Datugan

Shane Izon Datugan is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 3259 Catlin Ave, Quantico, VA 22134-5109. The NPI number 1538817036 was assigned on March 14, 2022 and the record was last updated on March 14, 2022.

Frequently asked questions

What is the NPI number of Shane Izon Datugan?

The NPI number is 1538817036.

What is the phone number of Shane Datugan?

The phone number listed for the practice location is (703) 784-1725.

Where is Shane Datugan located?

3259 Catlin Ave, Quantico, VA 22134-5109.

What is the taxonomy code for Shane Datugan?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Physician Assistant providers in Quantico

All Physician Assistant providers in Quantico, VA →