Individual
DR. SHANNON PENICK PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10810 CONNECTICUT AVENUE, KENSINGTON, MD 20895-2138
(301) 929-7100
(301) 929-7114
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT UNIT, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0101241142
VA
207Y00000X
Otolaryngology Physician
Primary
D0053881
MD
207YX0602X
Otolaryngic Allergy Physician
38383
CO
207YX0602X
Otolaryngic Allergy Physician
MD33647
DC
Other
Enumeration date
11/28/2006
Last updated
11/16/2011
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