Individual
MRS. SHANNON LYNNE MARRIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3800 FREDERICK AVE, BALTIMORE, MD 21229-3618
(410) 233-1400
(410) 233-1666
Mailing address
9203 PEACH BLOSSOM AVE, PERRY HALL, MD 21128-9785
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0001995
MD
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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