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Shane Carlos Carrillo, MD
Student in an Organized Health Care Education/Training Program in Richmond, Virginia
NPI 1114453511

Shane Carlos Carrillo is a Student in an Organized Health Care Education/Training Program based in Richmond, VA. Shane Carlos Carrillo practices in Richmond, VA and has the professional credentials of MD. The NPI Number for Shane Carlos Carrillo is 1114453511 and holds a License No. (Virginia).

The current practice location address for Shane Carlos Carrillo is 107 S. 5Th St., Richmond, VA and can be reached out via phone at 804-828-7912.

Location: 107 S. 5Th St., Richmond, VA, 23219
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114453511
Provider Name
Shane Carlos Carrillo
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
107 S. 5Th St., Richmond, VA, 23219
Phone Number
804-828-7912
Fax Number
Provider Enumeration Date
05/04/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
107 S. 5Th St.
City
Richmond
State
Virginia
Zip
23219
Phone Number
804-828-7912
Fax Number
person
Provider Business Mailing Address Details
Address
107 S. 5Th St.
City
Richmond
State
Virginia
Zip
23219
Phone Number
804-828-7912
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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