Individual
CHARLES ROY SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2841 DEBARR ROAD, SUITE 50, ANCHORAGE, AK 99508-2932
(907) 276-2811
(907) 276-2810
Mailing address
2841 DEBARR ROAD, SUITE 50, ANCHORAGE, AK 99508-2932
(907) 276-2811
(907) 276-2810
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2099
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD20991
—
AK
Enumeration date
11/17/2005
Last updated
04/24/2013
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