Individual
LYNWOOD PAGE SHANNON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1120 SE CARY PKWY, SUITE 100, CARY, NC 27511-7413
(919) 467-4992
(919) 232-5150
Mailing address
1120 SE CARY PKWY, SUITE 100, CARY, NC 27511-7413
(919) 467-4992
(919) 232-5150
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
104126
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2525753
UNITED HEALTHCARE
—
01
—
36164
BCBS
—
05
—
7936164
—
NC
Enumeration date
02/15/2006
Last updated
07/08/2007
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