Provider Demographics
NPI:1194741959
Name:MCLANE, SHAWN C (MD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:C
Last Name:MCLANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1000 BOULDERS PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5545
Mailing Address - Country:US
Mailing Address - Phone:804-320-4243
Mailing Address - Fax:804-282-1486
Practice Address - Street 1:6600 W BROAD ST STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1709
Practice Address - Country:US
Practice Address - Phone:804-320-4243
Practice Address - Fax:804-622-0552
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101051660207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA021792OtherCIGNA PROVIDER NUMBER
VA226104OtherANTHEM HEALTHKEEPERS
VA005822581Medicaid
VA226104OtherANTHEM PROVIDER NUMBER
VA4800263OtherUNITED HEALTHCARE
VA7050829OtherMAMSI PROVIDER NUMBER
VA94993OtherSOUTHERN HEALTH
VA11996OtherCARENET PROVIDER NUMBER
VA290011240OtherMEDICARE RAILROAD
VA006895400OtherBLACK LUNG PROVIDER NUMBE
VA7050829OtherMAMSI PROVIDER NUMBER
VA021792OtherCIGNA PROVIDER NUMBER