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General NPI Number Information
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NPI Number | 1972502987
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Entity Type | Individual
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Provider Name | SHANNON G MCELROY PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 315 S MAIN ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-3815
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Country | US
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Telephone | 336-349-3220
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Fax | 336-349-2725
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Provider Business Mailing Address
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Address Line | 315 S MAIN ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-3815
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Country | US
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Telephone | 336-349-3220
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Fax | 336-349-2725
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 102368
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License Number State | NC
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