DR. MD Mary Kelly Shanahan, NPI 1588661359
Obstetrics & Gynecology Physician in South Lake Tahoe, CA, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1588661359 |
| NPI Entity Type | Individual |
| Provider Name | DR. MD Mary Kelly Shanahan |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 1154 Emerald Bay Rd, South Lake Tahoe, CA, US |
| Provider Mailing Address | 1154 Emerald Bay Rd, South Lake Tahoe, CA, US, 961506288 |
| Is Sole Proprietor? | Yes |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Obstetrics & Gynecology Physician |
| Classification | |
| Group | |
| License No. | G78582 |
| License State | CA |
| Description | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 7055 | NV | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 1588661359 | CA | MEDICAID | 05 |
| 1588661359 | NV | MEDICAID | 05 |
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