Individual
ANGELA B. SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1679 OLD FANNIN RD STE E, FLOWOOD, MS 39232-8101
(601) 398-1949
(769) 216-3044
Mailing address
1679 OLD FANNIN RD STE E, FLOWOOD, MS 39232-8101
(601) 398-1949
(769) 216-3044
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
22009
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05307227
—
MS
Enumeration date
05/25/2007
Last updated
07/12/2021
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