Individual
DR. SHANNON ALTAZAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 376-1939
(740) 374-1693
Mailing address
1467 TORNES RD, LOWELL, OH 45744-7187
(225) 802-2197
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.015793
OH
207P00000X
Emergency Medicine Physician
3742
WV
207Q00000X
Family Medicine Physician
34.015793
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0485813
—
OH
Enumeration date
03/20/2018
Last updated
02/19/2026
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