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Individual

DR. JONATHAN MICHAEL SHANK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1515 6TH AVE S, BIRMINGHAM, AL 35233-1601
(205) 930-3555
(205) 930-3497
Mailing address
1515 6TH AVE S, BIRMINGHAM, AL 35233-1601
(205) 930-3555
(205) 930-3497

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
070775
GA

Other

Enumeration date
06/09/2012
Last updated
03/17/2018
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