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Individual

SHANNON M GULLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
7600 WOLF RIVER BLVD, STE 200, GERMANTOWN, TN 38138-1784
(901) 747-1000
Mailing address
PO BOX 5083, MEMPHIS, TN 38101-5083
(877) 448-8679

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
18706
MS
2085R0202X
Diagnostic Radiology Physician
2008-00055
NC
2085R0202X
Diagnostic Radiology Physician
Primary
42013
TN
2085R0202X
Diagnostic Radiology Physician
E-5160
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5910379
NC
Enumeration date
01/22/2007
Last updated
11/25/2024
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