| Doctor Name: | DR. SHANNON JAROSH WALSH |
| NPI Number: | 1427385319 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 0101237333 |
| Business Practice Address: | 11010 Lady Allison Ln Midlothian, VA - 231131186 |
| Business Phone Number: | 8042211689 |
| Business Fax Number: | |
| Mailing Address: | 11010 Lady Allison Ln, MIDLOTHIAN |
| State: | VA |
| Postal Code: | 231131186 |
| Phone Number: | 8042211689 |
| Fax Number: | |
| NPI Enumeration Date: | 11/12/2009 |
| NPI Last Update Date: | 06/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101237333 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |