Provider Demographics
NPI:1730250143
Name:MEHURG, SHANNON MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:MICHAEL
Last Name:MEHURG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-404-6800
Mailing Address - Fax:603-686-7244
Practice Address - Street 1:14 TSIENNETO RD STE 200A
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1647
Practice Address - Country:US
Practice Address - Phone:603-404-6800
Practice Address - Fax:603-686-7244
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2024-10-31
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Provider Licenses
StateLicense IDTaxonomies
NH18367207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease