Individual
SHANNON MARIE MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS
Contact information
Practice address
320 E NORTH AVE STE 401, PITTSBURGH, PA 15212-4756
(412) 359-4352
(412) 359-8285
Mailing address
320 E NORTH AVE STE 401, PITTSBURGH, PA 15212-4756
(412) 359-4352
(412) 359-8285
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA060355
PA
363AS0400X
Surgical Physician Assistant
Primary
MA060355
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103608062
—
PA
01
—
14382009
CAQH
—
Enumeration date
11/04/2018
Last updated
10/07/2020
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