Provider Demographics
NPI:1386804573
Name:SHANNON-CHELMAN, DEBORAH L
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:SHANNON-CHELMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BROOKLAND RD
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4739
Mailing Address - Country:US
Mailing Address - Phone:781-938-8388
Mailing Address - Fax:
Practice Address - Street 1:2 COURTHOUSE LN
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1715
Practice Address - Country:US
Practice Address - Phone:978-275-9444
Practice Address - Fax:978-275-9918
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program