Individual
SHANNON MITCHELL ST CLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
186 KIMEL PARK DR, WINSTON SALEM, NC 27103-6946
(336) 277-2000
(336) 277-2050
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-2000
(336) 277-2050
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2009-00666
NC
207UN0901X
Nuclear Cardiology Physician
Primary
2009-00666
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921382
—
NC
Enumeration date
05/22/2008
Last updated
10/25/2020
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