Provider Demographics
NPI:1760810279
Name:BEVINS, SHAUN (MPT)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:
Last Name:BEVINS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:SHAUN
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:659 S SALISBURY BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5458
Mailing Address - Country:US
Mailing Address - Phone:108-313-2264
Mailing Address - Fax:410-572-4041
Practice Address - Street 1:1915 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2607
Practice Address - Country:US
Practice Address - Phone:443-909-5882
Practice Address - Fax:443-909-5910
Is Sole Proprietor?:No
Enumeration Date:2013-10-18
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist