SHAW WENDI FORTUCHANG (NPI# 1205952231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205952231 |
| Entity Type | Individual |
| Full Name | SHAW WENDI FORTUCHANG |
| Other Name | SHAW WENDI WOODS |
| Credential | M.D. |
| Practice Address |
110 N Park Dr Fayetteville GA 30214-1645 |
| Practice Telephone | 7703766726 |
| Practice Fax Number | 7703766727 |
| Mailing Telephone | 7703766726 |
| Mailing Fax Number | 7703766727 |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2014-08-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
66108 | GA | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
66108 | GA | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
66108 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
110 N PARK DR |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609316694 | Suzanne Nicholas LLC | Psychiatry & Neurology | 2224 Riverfront Ln, Fayetteville, AR 72703-9527 | 2017-02-24 |
| 1417310491 | Murray Fork Clinic, PC | Psychiatry & Neurology | 6020 Morganton Road, Fayetteville, NC 28314-1352 | 2016-03-29 |
| 1003225491 | Johari Family Services, LLC | Psychiatry & Neurology | 701 Whitfield St, Fayetteville, NC 28306-1617 | 2014-08-11 |
| 1609154509 | Saguaro Group LLC | Psychiatry & Neurology | 2800 Breezewood Drive, Ste 100, Fayetteville, NC 28303-5282 | 2011-07-26 |
| 1699065110 | Jacquelyn Rae Lange-halley | Psychiatry & Neurology | 2580 E Joyce Blvd Ste 1, Fayetteville, AR 72703-3924 | 2011-04-18 |
| 1124343918 | Dorothee S Mecum | Psychiatry & Neurology | 28 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2010-04-05 |
| 1922269018 | Kevin M Lamm | Psychiatry & Neurology | 1724 Roxie Avenue, Fayetteville, NC 28304 | 2008-06-20 |
| 1780871152 | Atul Kantesaria Md Pllc | Psychiatry & Neurology | 105 Hunter Cir, Fayetteville, NC 28304-3407 | 2007-10-01 |
| 1942496005 | James Robert Parks | Psychiatry & Neurology | 102 E Sunbridge Dr, Suite 1, Fayetteville, AR 72703-2830 | 2007-09-21 |
| 1144353699 | Trevor Nagib Iskander | Psychiatry & Neurology | 280 Salt Springs St, Fayetteville, NY 13066-2258 | 2007-03-13 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.