Individual
DR. MATTHEW BRIAN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP EMERGENCY MEDICINE, JACKSONVILLE, FL 32209-6511
(904) 244-4107
Mailing address
PO BOX 44008, UFJP EMERGENCY MEDICINE, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME73606
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254799600
—
FL
Enumeration date
10/02/2006
Last updated
02/04/2011
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