# TERRY L SHIPE MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043450208
- **Authorized official:** DR. TERRY L SHIPE M.D. (OWNER)
- **Authorized official phone:** (260) 665-7595

## Contact information

- **Practice address:** 306 E MAUMEE ST, SUITE 2, ANGOLA, IN 46703-2035
- **Practice address phone:** (260) 665-7595
- **Practice address fax:** (260) 665-6586
- **Mailing address:** 306 E MAUMEE ST, SUITE 2, ANGOLA, IN 46703-2035
- **Mailing address phone:** (260) 665-7595
- **Mailing address fax:** (260) 665-6586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 01029019 | IN | — |
| 207Q00000X | Family Medicine Physician | 01029019 | IN | Yes |

## Other

- **Enumeration date:** 03/02/2009
- **Last updated:** 03/02/2009