Individual
CARLY ANN SHIEMBOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-4000
Mailing address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 612-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO2537
ME
207P00000X
Emergency Medicine Physician
OS015723
PA
207P00000X
Emergency Medicine Physician
OT013357
PA
207R00000X
Internal Medicine Physician
OT013357
PA
Other
Enumeration date
06/08/2010
Last updated
04/16/2019
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