Individual
PHILLIP PRICE SHADDUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 WILLIAM PENN PLZ, DURHAM, NC 27704-2150
(919) 220-5255
(919) 313-1276
Mailing address
120 WILLIAM PENN PLZ, DURHAM, NC 27704-2150
(919) 220-5255
(919) 313-1276
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
93-00312
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75341
BCBS NC
NC
05
—
8975341
—
NC
Enumeration date
11/30/2005
Last updated
09/23/2013
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