Individual
SHANNON SHAN JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3940 JOHN R RD, TROY, MI 48083-5688
(248) 455-4169
Mailing address
3940 JOHN R RD, TROY, MI 48083-5688
(947) 217-3223
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301104534
MI
207W00000X
Ophthalmology Physician
D81623
MD
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
4301104534
MI
Other
Enumeration date
04/04/2010
Last updated
07/20/2022
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