Individual
JILL SHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
251 E ANTIETAM ST, HAGERSTOWN, MD 21740
(301) 790-8501
Mailing address
PO BOX 1248, HAGERSTOWN, MD 21740-1248
(800) 938-2828
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D47458
MD
Other
Enumeration date
09/15/2005
Last updated
10/02/2007
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