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NPI Code Detail

MEDICARE: DR. SHANNON M ANKROM MD

MEDICARE: DR. SHANNON M ANKROM 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
1208600000XSurgery Physician169121DC
2208600000XSurgery Physician0116021552VA
3208600000XSurgery Physician35.098458OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649404138
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON M ANKROM MD
Provider Business Mailing Address
First Line : 1246 ASHLAND AVE STE 204
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-2861
Country : US
Telephone Number : 740-450-6147
Fax Number : 740-450-6157
Provider Business Practice Location Address
First Line : 2800 MAPLE AVE
Second Line : SUITE A
City : ZANESVILLE
State : OH
Zip : 43701-1716
Country : US
Telephone Number : 740-454-5221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2009
Last Update Date : 03/10/2026

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