| Doctor Name: | BRIAN HUGH SHANNON |
| NPI Number: | 1003214842 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APN |
| License Number: | 26NJ00533400 |
| Business Practice Address: | 1600 Haddon Ave Camden, NJ - 081033101 |
| Business Phone Number: | 8567573500 |
| Business Fax Number: | |
| Mailing Address: | 1600 Haddon Ave, CAMDEN |
| State: | NJ |
| Postal Code: | 081033101 |
| Phone Number: | 8567573500 |
| Fax Number: | |
| NPI Enumeration Date: | 12/10/2014 |
| NPI Last Update Date: | 04/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 26NJ00533400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |