Doctor Name: | WILLIAM J SHANAHAN |
NPI Number: | 1649262510 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME0032249 |
Business Practice Address: | 4511 N. Davis Hwy Suite C Pensacola, FL - 325032770 |
Business Phone Number: | 8504848448 |
Business Fax Number: | 8504793258 |
Mailing Address: | 4511 N. Davis Hwy Suite C, PENSACOLA |
State: | FL |
Postal Code: | 325032770 |
Phone Number: | 8504848448 |
Fax Number: | 8504793258 |
NPI Enumeration Date: | 08/17/2005 |
NPI Last Update Date: | 06/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/23/2006 |
NPI Reactivation Date: | 03/29/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME0032249 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |