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NPI Code Detail

MEDICARE: SHANNON BROOKE MYERS DO

MEDICARE: SHANNON BROOKE MYERS DO
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 PhysicianOT023340PA

General Provider Information

NPI Number : 1467200238
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON BROOKE MYERS DO
Provider Business Mailing Address
First Line : 95 LEONARD AVE BLDG 22ND
Second Line :
City : WASHINGTON
State : PA
Zip : 15301-3368
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 S CENTRAL AVE
Second Line :
City : CANONSBURG
State : PA
Zip : 15317-1550
Country : US
Telephone Number : 724-745-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2024
Last Update Date : 05/08/2024

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