Individual
SHANE T MALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
22748
ND
2085R0202X
Diagnostic Radiology Physician
4301105443
MI
2085R0202X
Diagnostic Radiology Physician
ME175471
FL
Other
Enumeration date
04/02/2014
Last updated
12/01/2025
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