Organization
SHANAHAN RHEUMATOLOGY AND IMMUNOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NICOLE COUTURE (BILLING AGENT)
(413) 772-8500
Entity
Organization
Contact information
Practice address
10208 CERNY STREET, WAKE MED BRIER CREEK MEDICAL PARK, RALEIGH, NC 27617
(919) 949-2228
Mailing address
10208 CERNY STREET, WAKE MED BRIER CREEK MEDICAL PARK, RALEIGH, NC 27617
(919) 949-2228
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
9801767
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890138J
—
NC
Enumeration date
11/25/2009
Last updated
02/01/2011
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