Individual
SHANNON TAYLOR INGWERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
330 E HIBISCUS BLVD, MELBOURNE, FL 32901-3155
(321) 724-2229
(321) 728-6668
Mailing address
330 E HIBISCUS BLVD, MELBOURNE, FL 32901-3155
(321) 724-2229
(321) 728-6681
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
DR.0056592
CO
207VX0000X
Obstetrics Physician
Primary
ME149728
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2012
Last updated
07/11/2023
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