# DR. KEVIN JOHN SHANAGHAN

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

## Provider details

- **NPI number:** 1750318283
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 20A18062 | CA | Yes |
| 207Q00000X | Family Medicine Physician | DO2758 | ME | — |
| 207Q00000X | Family Medicine Physician | OS007370E | PA | — |

## Other

- **Enumeration date:** 06/28/2006
- **Last updated:** 07/06/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001264101 | — | PA |
| 01 | — | 0527142000 | AMERIHEALTH 65 PA | PA |
| 01 | — | 080187668 | RAILROAD MEDICARE | PA |
| 01 | — | 104877 | JOHNS HOPKINS | PA |
| 01 | — | 140375 | UNISON-WMG HERR'S RIDGE | PA |
| 01 | — | 146180 | UNISON-WMG THURMONT | PA |
| 01 | — | 20020665 | AH MERCY-WMG HERR'S RIDGE | PA |
| 01 | — | 20026342 | AH MERCY-WMG THURMONT | PA |
| 01 | — | 219458 | MAMSI-WMG | PA |
| 05 | — | 403896 | — | MD |
| 01 | — | 50018543 | CAPITAL BC-WMG HERR'S RID | PA |
| 01 | — | 50021844 | CAPITAL BC-WMG THURMONT | PA |
| 01 | — | 50080314 | CAPITAL BC-WMG-ST.CHARLES | PA |
| 01 | — | 5122170 | AETNA | PA |
| 01 | — | 616924 | CAREFIRST MD BCBS | MD |
| 01 | — | 692270 | HIGHMARK BLUE SHIELD | PA |
| 01 | — | 7429 | GEISINGER | PA |
| 01 | — | P004726 | GATEWAY-WMG | PA |