Organization
TERRY L SHIPE MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY L SHIPE M.D. (OWNER)
(260) 665-7595
Entity
Organization
Contact information
Practice address
306 E MAUMEE ST, SUITE 2, ANGOLA, IN 46703-2035
(260) 665-7595
(260) 665-6586
Mailing address
306 E MAUMEE ST, SUITE 2, ANGOLA, IN 46703-2035
(260) 665-7595
(260) 665-6586
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01029019
IN
207Q00000X
Family Medicine Physician
Primary
01029019
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100329370A
—
IN
Enumeration date
03/02/2009
Last updated
03/02/2009
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