Individual
SHANNON NICOLE FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
14 MEMORIAL DR, SUITE A, DOYLESTOWN, PA 18901
(215) 348-2992
(215) 348-2052
Mailing address
1456 FERRY RD, STE 402, DOYLESTOWN, PA 18901-2307
(215) 348-2992
(215) 348-2052
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA003232L
PA
Other
Enumeration date
07/01/2008
Last updated
04/13/2018
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