Search › Georgia › 208M00000X
Shannon Willis, MD
NPI 1487971263 · on the registry since 2010
Practice
- Address
- 1000 Medical Center Blvd
Ground Floor Gme Office
Lawrenceville, GA 30046 - Phone
- (706) 593-1389
- Organisation at this address
- Northside Hospital Inc
Northside Hospital, Inc.
Gwinnett Pathology Assoc Pc
Gwinnett Medical Group, Inc
Gwinnett Physician Group, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 497
Additional practice sites
- 22 Bramhall St, Portland, ME
- 25 June St, Sanford, ME
- 1 Medical Center Dr, Biddeford, ME
Registry record
- Primary taxonomy
- 208M00000X
208M00000X
- Also registered as
- 207R00000X
207R00000X
208M00000X - Licence states on file
- GA, ME
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-06-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia