Individual
SHANNON SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
593 EDDY ST, APC 406, PROVIDENCE, RI 02903-4923
(401) 444-5031
Mailing address
593 EDDY ST, APC 406, PROVIDENCE, RI 02903-4923
(401) 444-5031
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD16784
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2013
Last updated
12/28/2022
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