Individual
JUSTIN SHANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(800) 789-7366
Mailing address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT231777
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MT213777
PA
Other
Enumeration date
05/23/2024
Last updated
06/20/2025
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