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Contact Information

SHAUN T BROTHERS, PAC
593 EDDY ST
PROVIDENCE, RI02903-4923
 Phone: 401-444-5175
 Fax: 401-444-8874
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SHAUN T BROTHERS · (Male)

NPI # 1588990790
Status Active
Credentials PAC
Entity Individual
Enumeration date 10/22/2009
Last updated 08/07/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 0010-02084
  • RI License # PA00703
Hospital affiliation(s)
  • REX HOSPITAL - (Acute Care)
    4420 LAKE BOONE TRAIL
    RALEIGH, NC 27607
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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