Individual
DR. SHANNON MARIE MCCOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 461-0050
(757) 461-4538
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 627-4512
(757) 461-4538
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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