Individual
DR. CLAUDE K SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506
(304) 598-6900
(304) 598-6914
Mailing address
P. O. BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12342
WV
Other
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
Enumeration date
08/31/2006
Last updated
10/22/2010
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