Individual
MARY TERESA SHINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
E2219
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138361001
—
AR
01
—
5L297
BLUE
AR
Enumeration date
05/11/2006
Last updated
04/25/2011
Update your record
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