Healthcare Provider Details

I. General information

NPI: 1205877552
Provider Name (Legal Business Name): DANIEL LAWRENCE SHINNERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 06/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9103 FRANKLIN SQUARE DR SUITE 300
BALTIMORE MD
21237-3900
US

IV. Provider business mailing address

501 FAIRMOUNT AVENUE SUITE 103
TOWSON MD
21286
US

V. Phone/Fax

Practice location:
  • Phone: 410-682-5282
  • Fax: 410-682-5286
Mailing address:
  • Phone: 410-494-7921
  • Fax: 410-902-8247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD53694
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: