Individual
TIMOTHY J SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 UNIVERSITY PKWY, SUITE 1000, AIKEN, SC 29801
(803) 644-4264
(803) 649-0543
Mailing address
410 UNIVERSITY PKWY, SUITE 1000, AIKEN, SC 29801
(803) 644-4264
(803) 649-0543
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
17950
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T18656
—
SC
Enumeration date
01/30/2006
Last updated
10/09/2007
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