# DR. CLAUDE K SHANNON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073625521
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 12342 | WV | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 10/22/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0007709000 | — | WV |
| 05 | — | 0056507000 | — | WV |
| 01 | — | CA9811 | MEDICARE RAILROAD CARRIER | WV |
| 01 | — | PR9255725 | MEDICARE GROUP NUMBER | WV |
| 01 | — | SH0506016 | PMMG MEDICARE ID | WV |