Individual
DR. TERRY L SHIPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
306 E MAUMEE ST STE 201, ANGOLA, IN 46703-2035
(260) 665-7595
(260) 665-6586
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01029019A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100329370A
—
IN
Enumeration date
05/27/2005
Last updated
11/15/2022
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