Individual
DR. WILLIAM BARTHOLOMEW SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1061 X RAY DR, GASTONIA, NC 28054-7489
(704) 861-8557
(704) 853-0003
Mailing address
1061 X RAY DR, GASTONIA, NC 28054-7489
(704) 861-8557
(704) 853-0003
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25080
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030118
BCBS OF SC
SC
01
—
0840038
UNITED HEALTHCARE OF NC
NC
01
—
0933289001
CIGNA HEALTHCARE OF NC
NC
01
—
17924
WELLPATH COVENTRY
NC
01
—
2803998
AETNA USHC
—
01
—
75443
BLUE CROSS BLUE SHIELD
NC
01
—
81047089
BCBS OF AL
AL
01
—
8690
PARTNERS NATIONALHEALTH
NC
05
—
8975443
—
NC
Enumeration date
11/10/2005
Last updated
12/03/2010
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