Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 0101243747 | VA |
N | 207V00000X | Obstetrician & Gynecologist | 176486 | NC |
N | 207V00000X | Obstetrician & Gynecologist | TP262 | KY |
N | 207VE0102X | Reproductive Endocrinologist | TP262 | KY |
NPI | 1023165313 |
---|---|
Provider Name | Dr. Shawn Dean Redding |
First Address | South Boston, VA 24592-1630 |
Second Address | South Boston, VA 24592-1630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 13/04/2021 |