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NPI Code Detail

MEDICARE: DR. THOMAS SHANNON ANDERSON MD

MEDICARE: DR. THOMAS SHANNON ANDERSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207T00000XNeurological Surgery Physician0090-01409NC
2207T00000XNeurological Surgery Physician25231SC

General Provider Information

NPI Number : 1275609489
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS SHANNON ANDERSON MD
Provider Business Mailing Address
First Line : PO BOX 749340
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1625 HOSPITAL DR
Second Line :
City : MT PLEASANT
State : SC
Zip : 29464-3698
Country : US
Telephone Number : 843-849-1551
Fax Number : 843-884-0629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 12/23/2024

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Directions to “ DR. THOMAS SHANNON ANDERSON MD” Practice Location

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