Provider Demographics
NPI:1952482853
Name:ADAMS, SHANNON PATRICK (DO / MS)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:PATRICK
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DO / MS
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Other - Credentials:
Mailing Address - Street 1:620 JOHN PAUL JONES CIR
Mailing Address - Street 2:NMCP - PSYCH DEPT ADMIN OFFICE - BLDG #3 - FLOOR #1
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23708-2197
Mailing Address - Country:US
Mailing Address - Phone:602-692-6944
Mailing Address - Fax:757-953-6907
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:NMCP - PSYCH DEPT ADMIN OFFICE - BLDG #3 - FLOOR #1
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2197
Practice Address - Country:US
Practice Address - Phone:602-692-6944
Practice Address - Fax:757-953-6907
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102201902208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice