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NPI Code Detail

MEDICARE: DR. SHANNON MARIE MASNERI D.O.

MEDICARE: DR. SHANNON MARIE MASNERI D.O.
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
1207Q00000XFamily Medicine PhysicianDOS1019HI
2207Q00000XFamily Medicine Physician2014-01987NC

General Provider Information

NPI Number : 1487727202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON MARIE MASNERI D.O.
Provider Business Mailing Address
First Line : 6412 PEPPERMILL DR
Second Line :
City : OAK RIDGE
State : NC
Zip : 27310-9803
Country : US
Telephone Number : 910-992-1457
Fax Number :
Provider Business Practice Location Address
First Line : 1510 NC HIGHWAY 68 N # 1510
Second Line :
City : OAK RIDGE
State : NC
Zip : 27310-9733
Country : US
Telephone Number : 336-644-0111
Fax Number : 336-268-3119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 04/23/2021

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Directions to “ DR. SHANNON MARIE MASNERI D.O.” Practice Location

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