Individual
SHANNON T. HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2302 PARKLAKE DR NE, ATLANTA, GA 30345-2896
(678) 894-0288
Mailing address
910 DEERFIELD CROSSING DR APT 2113, ALPHARETTA, GA 30004-1803
(252) 529-3544
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME140317
FL
Other
Enumeration date
06/29/2016
Last updated
06/09/2021
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