Individual
SHANNON FLYNN RUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
137596
CA
207Y00000X
Otolaryngology Physician
4301117284
MI
207YS0123X
Facial Plastic Surgery Physician
Primary
4301117284
MI
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
4301117284
MI
Other
Enumeration date
04/30/2014
Last updated
09/15/2023
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