Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | OS016023 | PA |
NPI | 1003043803 |
---|---|
Provider Name | Dr. Shannon K Alsop |
First Address | Chicago, IL 60608-1169 |
Second Address | King Of Prussia, PA 19406-2860 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 13/10/2020 |