Provider Demographics
NPI:1518911726
Name:BOWNDS, SHANNON ELOI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:ELOI
Last Name:BOWNDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:26520 N ALMA SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-8052
Mailing Address - Country:US
Mailing Address - Phone:952-303-1531
Mailing Address - Fax:952-303-1531
Practice Address - Street 1:26520 N ALMA SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-8052
Practice Address - Country:US
Practice Address - Phone:952-303-1531
Practice Address - Fax:952-303-1531
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ412112085R0202X
UT5900184-12052085R0202X
CODR.00611092085R0202X
ND176912085R0202X
ARE-150092085R0202X
MN494912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I52384Medicare UPIN