Provider Demographics
NPI:1134005739
Name:SHAGUN, FNU (MD)
Entity type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:SHAGUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TALLAHASSEE MEMORIAL HEALTHCARE
Mailing Address - Street 2:1115 W. CALL STREET
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32306
Mailing Address - Country:US
Mailing Address - Phone:850-431-8261
Mailing Address - Fax:850-431-8251
Practice Address - Street 1:FSU COLLEGE OF MEDICINE AT TALLAHASSEE MEMORIAL HEALTHC
Practice Address - Street 2:1300 MICCOSUKEE RD
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-431-8261
Practice Address - Fax:850-431-8251
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program