Individual
MOIRA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 N SILVERBELL RD, SUITE 100, TUCSON, AZ 85745-7062
(520) 777-2288
(520) 777-2290
Mailing address
2202 N FORBES BLVD, TUCSON, AZ 85745-1412
(520) 777-2288
(520) 777-2290
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
12820
AZ
208D00000X
General Practice Physician
Primary
12820
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246521
—
AZ
Enumeration date
01/04/2006
Last updated
07/22/2011
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