Individual
MICHAEL J SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4017 RAWLINS ST, CHEYENNE, WY 82001-1800
(307) 635-2562
(307) 638-2074
Mailing address
PO BOX 20970, CHEYENNE, WY 82003-7020
(307) 635-2562
(307) 638-2074
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
7800A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125526600
—
WY
05
—
93574363
—
CO
01
—
P00649757
RAILROAD MEDICARE
WY
Enumeration date
06/03/2006
Last updated
12/20/2022
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