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General NPI Number Information
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NPI Number | 1649404138
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Entity Type | Individual
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Provider Name | SHANNON M HANLEY MD
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Gender | Female
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 2800 MAPLE AVE SUITE A
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City | ZANESVILLE
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State | OH
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Zip | 43701-1716
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Country | US
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Telephone | 740-454-5221
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Fax |
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Provider Business Mailing Address
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Address Line | 1246 ASHLAND AVE SUITE 204
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City | ZANESVILLE
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State | OH
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Zip | 43701-2861
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Country | US
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Telephone | 740-450-6147
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Fax | 740-450-6157
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35.098458
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 169121
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0116021552
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License Number State | VA
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