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General NPI Number Information
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NPI Number | 1932595162
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Entity Type | Individual
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Provider Name | SHANNON RAYMAN D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 480 CENTRAL AVE
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City | PEARL HARBOR
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State | HI
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Zip | 96860-4908
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Country | US
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Telephone | 888-683-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 328 AVERY RD
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City | FRANCESTOWN
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State | NH
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Zip | 03043-3501
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Country | US
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Telephone | 757-651-1530
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Fax | 757-651-1530
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 18687
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 010602
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License Number State | AZ
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