Mccormack, Shannon E.

Mccormack, Shannon E. is an individual health care provider with primary practice located at 1969 W Hart Rd Beloit Memorial Hospital, Beloit WI 53511-2230. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Mccormack, Shannon E. can be contacted via phone (608) 363-5971.

Contact Information

Primary practice address
1969 W Hart Rd Beloit Memorial Hospital Beloit WI 53511-2230
Phone: (608) 363-5971
Fax: (608) 363-5737
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 5101019893 Michigan
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 5101019893 Michigan
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 64097-21 Wisconsin
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 64097-21 Wisconsin

Profile Details

NPI number 1588924054
LBN Legal business name Mccormack, Shannon E.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2012
Last updated Nov 21st, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588924054 NPPES
Wisconsin MEDICAID 100045471

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