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Individual
MICHAEL CHARLES SHIPMAN
Active
Individual
MICHAEL CHARLES SHIPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA000192L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028667
MEDICARE
PA
01
—
1437159951
NPI
PA
01
—
158841
MEDICARE GROUP NUMBER
PA
Enumeration date
07/27/2005
Last updated
06/07/2011
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