Provider Demographics
NPI:1649442682
Name:MCDONOUGH, PATRICK SHANNON (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:SHANNON
Last Name:MCDONOUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:600 RIDGELY AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1045
Mailing Address - Country:US
Mailing Address - Phone:410-266-8049
Mailing Address - Fax:410-266-8054
Practice Address - Street 1:600 RIDGELY AVE STE 130
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1045
Practice Address - Country:US
Practice Address - Phone:410-266-8049
Practice Address - Fax:410-266-8054
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0085433208800000X
NE24506208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology