Provider Demographics
NPI:1679801971
Name:SEUFERT, SHAUN G (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:G
Last Name:SEUFERT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 BRADLEY PINES DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2042
Mailing Address - Country:US
Mailing Address - Phone:910-799-7286
Mailing Address - Fax:
Practice Address - Street 1:6861 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-9724
Practice Address - Country:US
Practice Address - Phone:910-793-4924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist