Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 0101266491 | VA |
N | 207VX0201X | Gynecologic Oncologist | R1694 | TX |
NPI | 1023307360 |
---|---|
Provider Name | Dr. Shannon Armbruster |
First Address | Roanoke, VA 24016-4962 |
Second Address | Roanoke, VA 24016-4962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 10/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
371466901 | (05) | TX |