Individual
DR. SHANNON LEIGH CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12 KANAWHA TER, SAINT ALBANS, WV 25177
(304) 201-1130
(304) 201-1134
Mailing address
3200 MACCORKLE AVE SE, SUITE B16, CHARLESTON, WV 25304
(304) 388-5848
(304) 388-9654
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24882
WV
208M00000X
Hospitalist Physician
24882
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810024872
—
WV
Enumeration date
04/20/2009
Last updated
08/03/2018
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