Provider Demographics
NPI:1427880053
Name:GAINES, SHAWN WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:WILLIAM
Last Name:GAINES
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 SOUTH STATE STREET
Mailing Address - Street 2:MAILCODE 3007
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901
Mailing Address - Country:US
Mailing Address - Phone:302-725-3557
Mailing Address - Fax:
Practice Address - Street 1:804 N. DUPONT HWY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-0119
Practice Address - Country:US
Practice Address - Phone:302-725-3557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-0018835207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine