Healthcare Provider Details
I. General information
NPI: 1346220167
Provider Name (Legal Business Name): SHANNON H MCGRANAHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/18/2006
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3928 WASHINGTON RD SUITE 230
MC MURRAY PA
15317-2537
US
IV. Provider business mailing address
3928 WASHINGTON RD SUITE 230
MC MURRAY PA
15317-2537
US
V. Phone/Fax
- Phone: 724-941-1866
- Fax: 724-941-1647
- Phone: 724-941-1866
- Fax: 724-941-1647
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD071066L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: