Individual
MICHAEL SHANNON PEATTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
26508
AL
207R00000X
Internal Medicine Physician
Primary
16500
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051526716
—
AL
05
—
06800711
—
MS
01
—
51526716
BCBS
AL
Enumeration date
06/19/2006
Last updated
02/07/2012
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