Individual
MS. SHANNA MARIE ZWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1044 N MASON RD, DIV SURG COLON/RECTAL, STE 310, SAINT LOUIS, MO 63141-6431
(314) 454-7177
(888) 425-7946
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-7177
(888) 425-7946
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2022023073
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220031343
—
MO
Enumeration date
04/02/2013
Last updated
04/17/2025
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