Individual
DR. LARRY ROLAND SHANNON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5771 ROYAL MILE BLVD, SALISBURY, MD 21801-2326
(410) 805-7039
Mailing address
5771 ROYAL MILE BLVD, SALISBURY, MD 21801-2326
(410) 805-7039
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
036.121453
IL
207T00000X
Neurological Surgery Physician
Primary
D72508
MD
Other
Enumeration date
07/09/2009
Last updated
11/21/2014
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