Individual
DR. CLARENCE SHANNON IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6900 GEORGIA AVE, NW , WARD 44, WRAMC DEPARTMENT OF SURGERY, WASHINGTON, DC 20307-5001
(202) 782-0039
Mailing address
3818 MONTROSE DRIVEWAY, CHEVY CHASE, MD 20815-4702
(301) 656-8772
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
044586
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
044586
GA
Other
Enumeration date
04/13/2007
Last updated
09/11/2025
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