Individual
JOSEPH P. SHRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1245 42ND AVE, GULFPORT, MS 39501-2666
(228) 864-8049
(228) 864-7655
Mailing address
1245 42ND AVE, GULFPORT, MS 39501-2666
(228) 864-8049
(228) 864-7655
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
11871
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11871
MEDICAL LIC
MS
05
—
1316202
—
LA
Enumeration date
10/02/2006
Last updated
02/05/2014
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