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1295791580
SHANNON DOHERTY
BINGHAM FARMS, MI
NPI
1295791580
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: MI 4704140193)
Enumeration Date
2006-04-25
Last Update Date
2017-04-12
Business Address
-- SHANNON DOHERTY CRNA
30200 TELEGRAPH RD SUITE 220
BINGHAM FARMS, MI 48025-4502
Phone number: 248-258-5058
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Mailing Address
-- SHANNON DOHERTY CRNA
5445 MYRON RD
GRANT TOWNSHIP, MI 48032-2403
Phone number:
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