Individual
DR. TRISTAN J SHOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14205 PARK CENTER DR, SUITE 204, LAUREL, MD 20707-5246
(240) 786-1001
Mailing address
9900 GREENBELT RD, SUITE E117, LANHAM, MD 20706-2255
(240) 786-1001
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D0068884
MD
208100000X
Physical Medicine & Rehabilitation Physician
MD038330
DC
Other
Enumeration date
02/14/2007
Last updated
06/30/2021
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