Provider Demographics
NPI:1992690085
Name:CALHOUN, SHAUN MICHAEL (PA-S)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:MICHAEL
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 PROXIMITY DR APT 1421
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7952
Mailing Address - Country:US
Mailing Address - Phone:716-316-2966
Mailing Address - Fax:
Practice Address - Street 1:2020 PROXIMITY DR APT 1421
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-7952
Practice Address - Country:US
Practice Address - Phone:716-316-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant