Provider Demographics
NPI:1922240589
Name:AYMES, SHANNON ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:ELIZABETH
Last Name:AYMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHANNON
Other - Middle Name:ELIZABETH
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1208 PEARSON FARMS RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4867
Mailing Address - Country:US
Mailing Address - Phone:919-924-3650
Mailing Address - Fax:
Practice Address - Street 1:590 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-8403
Practice Address - Country:US
Practice Address - Phone:984-974-4881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-29
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08533200207R00000X
NC2012-00474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine