Provider Demographics
NPI:1013211317
Name:SHANNON, KERRY LEE (MD, DRPH, MPH)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:LEE
Last Name:SHANNON
Suffix:
Gender:F
Credentials:MD, DRPH, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE JOHNS HOPKINS HOSPITAL
Mailing Address - Street 2:1830 E. MONUMENT ST, SUITE 6-100
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:THE JOHNS HOPKINS HOSPITAL
Practice Address - Street 2:1830 E. MONUMENT ST, SUITE 6-100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-29
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD89056207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine