Healthcare Provider Details

I. General information

NPI: 1326251299
Provider Name (Legal Business Name): SHANNON LEIGH HUGGINS-PUHALLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HALKET ST
PITTSBURGH PA
15213-3108
US

IV. Provider business mailing address

603 PONDEROSA CT FL G-600
GIBSONIA PA
15044-6162
US

V. Phone/Fax

Practice location:
  • Phone: 412-641-4530
  • Fax:
Mailing address:
  • Phone: 614-406-3815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD-431596
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: