National Provider Identifier
Shannon Fourtner, MD
Shannon Fourtner, MD is listed in the NPPES registry with a primary specialty of Pediatric Endocrinology Physician in Williamsville, NY and a listed phone number of (585) 201-7112.
Profile Overview
- NPI
- 1225111651
- Provider Type
- Individual
- Primary Specialty
- Pediatric Endocrinology Physician
- Enumeration Date
- October 21, 2006
- Last Updated
- March 07, 2025
Practice Location
- 8203 Main St Ste 14
- Williamsville, NY 14221-6051
Phone: (585) 201-7112
Specialties
- Pediatric Endocrinology Physician (2080P0205X)
Full Record
- NPI
- 1225111651
- Entity Type
- Individual
- Last Name
- Fourtner
- First Name
- Shannon
- Credential
- MD
- Mailing Street Address
- 8203 Main St Ste 14
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-6051
- Mailing Country
- US
- Mailing Phone
- (585) 201-7112
- Mailing Fax
- (585) 201-7128
- Practice Street Address
- 8203 Main St Ste 14
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-6051
- Practice Country
- US
- Practice Phone
- (585) 201-7112
- Practice Fax
- (585) 201-7128
- Enumeration Date
- October 21, 2006
- Last Updated
- March 07, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- March 07, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Endocrinology Physician (2080P0205X)
- Other Identifiers
- 000528154001 (Bc/Bs), 050805000017 (Fidelis), 1212950 (Iha), 02657463 (NY), 00027224401 (Univera), 1019564320001 (PA Medicaid)