Individual
SHANNON B ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 SAINT VINCENTS DR, SUITE 500, NORTH TOWER, BIRMINGHAM, AL 35205-1620
(205) 933-8334
(205) 933-8466
Mailing address
800 SAINT VINCENTS DR, SUITE 500, NORTH TOWER, BIRMINGHAM, AL 35205-1620
(205) 933-8334
(205) 933-8466
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
29221
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138048
—
AL
01
—
511-15776
BCBS
AL
Enumeration date
06/07/2007
Last updated
01/18/2018
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