Basic Information
Provider Information
NPI: 1588981047
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MERON
FirstName: SHANNON
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SIMPSON
OtherFirstName: SHANNON
OtherMiddleName: ELIZABETH
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 50 SCHENCK PKWY
Address2: 1C412 HEALTH SCIENCES CENTER
City: ASHEVILLE
State: NC
PostalCode: 288033499
CountryCode: US
TelephoneNumber: 8286811527
FaxNumber:  
Practice Location
Address1: 50 N. MEDICAL DR.
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 84132
CountryCode: US
TelephoneNumber: 8015812121
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/23/2010
LastUpdateDate: 12/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X2016-02393NCY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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