Wise, Shannon Davis
Wise, Shannon Davis is an individual health care provider with primary practice located at 730 Goodlette-Frank Rd N Ste 100 , Naples FL 34102-5617. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Wise, Shannon Davis can be contacted via phone (239) 351-2990.Contact Information
Primary practice address
730 Goodlette-Frank Rd N Ste 100
Naples FL 34102-5617
Phone: (239) 351-2990
Fax: (239) 300-4128
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME120329 | Florida |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 16178 | Florida |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME120329 | Florida |
Profile Details
| NPI number | 1891088910 |
|---|---|
| LBN Legal business name | Wise, Shannon Davis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2011 |
| Last updated | Mar 10th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891088910 | NPPES |
| Florida | MEDICAID | 012206800 | |
| Florida | Other | HV151Y | |
| Florida | Other | 14W2L |
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