Provider Demographics
NPI:1013102482
Name:STARMAN, SHANNAN CHRISTINE (DC)
Entity type:Individual
Prefix:DR
First Name:SHANNAN
Middle Name:CHRISTINE
Last Name:STARMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11535 PARK WOODS CIR
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4490
Mailing Address - Country:US
Mailing Address - Phone:770-521-1114
Mailing Address - Fax:770-521-1194
Practice Address - Street 1:11535 PARK WOODS CIR
Practice Address - Street 2:SUITE D
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4490
Practice Address - Country:US
Practice Address - Phone:770-521-1114
Practice Address - Fax:770-521-1194
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCDMRMedicare UPIN