Individual
DR. SHANNON E FULP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4348 ELECTRIC RD, ROANOKE, VA 24018-0720
(540) 769-0700
(540) 772-8159
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101279712
VA
Other
Enumeration date
09/15/2005
Last updated
06/11/2024
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