Provider Demographics
NPI:1346220167
Name:MCGRANAHAN, SHANNON H (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:H
Last Name:MCGRANAHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:HENDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3928 WASHINGTON RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2537
Mailing Address - Country:US
Mailing Address - Phone:724-941-1866
Mailing Address - Fax:724-941-1647
Practice Address - Street 1:3928 WASHINGTON RD
Practice Address - Street 2:SUITE 230
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2537
Practice Address - Country:US
Practice Address - Phone:724-941-1866
Practice Address - Fax:724-941-1647
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071066L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018130800006Medicaid
PA0018130800006Medicaid
PA038898R7RMedicare PIN