Individual
SHIBU PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1267 HIGHWAY 54 W STE 2200, FAYETTEVILLE, GA 30214-2110
(770) 716-0051
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 277-2000
(336) 277-2050
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
0101279895
VA
207RC0000X
Cardiovascular Disease Physician
2012-02030
NC
207RC0000X
Cardiovascular Disease Physician
Primary
98806
GA
Other
Enumeration date
10/12/2006
Last updated
05/16/2024
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