Individual
KIMBERLY LAUREN SHAMPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
269617
MA
2085R0202X
Diagnostic Radiology Physician
Primary
4301102531
MI
2085R0202X
Diagnostic Radiology Physician
LL34820
SC
Other
Enumeration date
06/22/2012
Last updated
01/10/2019
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