DR. MARY KELLY SHANAHAN MD NPI 1588661359

NPI Information

DR. Mary Kelly Shanahan, MD is an obstetrics gynecology in South Lake Tahoe, CA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. Mary Kelly Shanahan, MD NPI is 1588661359. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1154 EMERALD BAY RD
SOUTH LAKE TAHOE, CA
ZIP 96150-288
Phone: (530) 542-4961
Fax: (530) 542-4964

The enumeration date for this NPI number is 7/7/2005 and was last updated on 4/3/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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