Shannon, Steven

Shannon, Steven is an individual health care provider with primary practice located at 3801 Market St Mab #111, Philadelphia PA 19104-3153. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Shannon, Steven can be contacted via phone (215) 662-9563.

Contact Information

Primary practice address
3801 Market St Mab #111 Philadelphia PA 19104-3153
Phone: (215) 662-9563
Fax: (215) 243-8818
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X SC-004744-2 Pennsylvania

Profile Details

NPI number 1669460101
LBN Legal business name Shannon, Steven
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Oct 10th, 2012 - about 13 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 1669460101 NPPES
Pennsylvania MEDICAID 1009461910001

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