Individual
SHANIQUE BROWN KILGALLON
Active
Individual
SHANIQUE BROWN KILGALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C1-0013749
DE
207L00000X
Anesthesiology Physician
MD445846
PA
207L00000X
Anesthesiology Physician
MT192730
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331247EJL
MEDICARE PTAN
PA
Enumeration date
06/25/2008
Last updated
12/21/2020
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