Provider Demographics
NPI:1093913865
Name:HEINRICH, SHANNON CHRISTIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:CHRISTIAN
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2861
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2861
Mailing Address - Country:US
Mailing Address - Phone:256-410-1374
Mailing Address - Fax:888-960-5113
Practice Address - Street 1:500 JOHN ALDRIDGE DR
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661
Practice Address - Country:US
Practice Address - Phone:256-383-4541
Practice Address - Fax:888-960-5113
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO1056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine