Individual
MICHAEL B SHANNON
Active
Individual
MICHAEL B SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
35-05-2695-5
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0619156
—
OH
01
—
31116457500
BWC
OH
Enumeration date
07/26/2005
Last updated
08/07/2014
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