Individual
SHANNON TERESA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 MEDICAL CENTER BLVD, GROUND FLOOR GME OFFICE, LAWRENCEVILLE, GA 30046-7694
(706) 593-1389
Mailing address
1000 MEDICAL CENTER BLVD, GROUND FLOOR GME OFFICE, LAWRENCEVILLE, GA 30046-7694
(706) 593-1389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
075178
GA
207R00000X
Internal Medicine Physician
MD29422
ME
208M00000X
Hospitalist Physician
Primary
075178
GA
208M00000X
Hospitalist Physician
MD29422
ME
Other
Enumeration date
05/03/2010
Last updated
06/12/2025
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