Individual
RICHARD P. SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
LEE ST FL 1, CHARLOTTESVILLE, VA 22908-0001
(434) 243-1000
(434) 982-1998
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101255838
VA
207RC0000X
Cardiovascular Disease Physician
MD061219L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001631800002
—
PA
Enumeration date
08/10/2005
Last updated
04/07/2014
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