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Individual

DR. SHANNON MARIE MCCOLE

Active
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Individual

DR. SHANNON MARIE MCCOLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101056000
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0591L
NC BC/BS
NC
05
1598729444
VA
01
305195
ANTHEM FF AVE
VA
01
305196
ANTHEM GRESHAM DR
VA
01
4133834
UHC/MAMSI
VA
01
60681
SHP/OHP
VA
05
890591L
NC
01
PAR
VA PREMIER HEALTH
VA
01
PAR
AETNA
VI
Enumeration date
04/16/2006
Last updated
01/27/2009
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