Individual
THOMAS H SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 720-7449
Mailing address
PO BOX 280, FORT MEADE, SD 57741-0280
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
3709
SD
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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