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NPI Code Detail

MEDICARE: DR. SHANNON RAYMAN D.O.

MEDICARE: DR. SHANNON RAYMAN 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 Physician010602AZ

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 : 1932595162
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON RAYMAN D.O.
Provider Business Mailing Address
First Line : 328 AVERY RD
Second Line :
City : FRANCESTOWN
State : NH
Zip : 03043-3501
Country : US
Telephone Number : 757-651-1530
Fax Number : 757-651-1530
Provider Business Practice Location Address
First Line : 480 CENTRAL AVE
Second Line :
City : PEARL HARBOR
State : HI
Zip : 96860-4908
Country : US
Telephone Number : 888-683-2778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2015
Last Update Date : 06/25/2026

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