Individual
SHANNON L HILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1074 ASHBURY DR, DECATUR, GA 30030-4165
(404) 593-7912
Mailing address
1074 ASHBURY DR, DECATUR, GA 30030-4165
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003099
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I970234
MEDICARE PTAN
GA
Enumeration date
05/02/2012
Last updated
06/23/2015
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