Dr SHANNON MARIE SULLIVAN is a female medical professional, specializing in Family Medicine. She graduated in 2015 from Loyola University Of Chicago, Stritch School Of Medicine.
THEDACARE INCORPORATED
2005 MIDWAY RD
MENASHA
WI
549527002
Tel: 9208328500
| Npi | 1972998680 |
| Pac Id | 8820365976 |
| Professional Enrollment Id | I20181002000755 |
| Last Name | SULLIVAN |
| First Name | SHANNON |
| Middle Name | MARIE |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialty 1 | |
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| Organization Legal Name | THEDACARE INCORPORATED |
| Group Practice Pac Id | 1759294887 |
| Number Of Group Practice Members | 478 |
| Line 1 Street Address | 2005 MIDWAY RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | MENASHA |
| State | WI |
| Zip Code | 549527002 |
| Phone Number | 9208328500 |
| Hospital Affiliation Ccn 1 | 520045 |
| Hospital Affiliation Lbn 1 | THEDA CLARK MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 520160 |
| Hospital Affiliation Lbn 2 | THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC |
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| Hospital Affiliation Lbn 3 | |
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| Professional Accepts Medicare Assignment | Y |
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