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NPI Code Detail

MEDICARE: SHANNON SALERNO MD

MEDICARE: SHANNON SALERNO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianDR.0071502CO
2207Q00000XFamily Medicine PhysicianR-11955IA

General Provider Information

NPI Number : 1275158131
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON SALERNO MD
Provider Business Mailing Address
First Line : 4650 SIGNAL TREE DR STE 1200
Second Line :
City : TIMNATH
State : CO
Zip : 80547-4908
Country : US
Telephone Number : 970-237-7415
Fax Number : 970-237-7420
Provider Business Practice Location Address
First Line : 4650 SIGNAL TREE DR STE 1200
Second Line :
City : TIMNATH
State : CO
Zip : 80547-4908
Country : US
Telephone Number : 970-237-7415
Fax Number : 970-237-7420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2020
Last Update Date : 07/28/2023

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Directions to “ SHANNON SALERNO MD” Practice Location

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