Individual
DR. SHANA JEANELLE GAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1221 MERCANTILE LN, LARGO, MD 20774-5374
(301) 386-6800
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0069501
MD
Other
Enumeration date
05/30/2008
Last updated
06/14/2021
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