Individual
SHANNON N RADOMSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
(410) 521-7669
Mailing address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
(410) 521-7669
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D91293
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2019
Last updated
07/13/2021
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