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Individual

DR. JOSEPH R SHIBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-0411
Mailing address
PO BOX 44008, UFJP-PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1013
NC
207P00000X
Emergency Medicine Physician
ME100022
FL
207P00000X
Emergency Medicine Physician
N4745
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME100022
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003105970A
GA
01
129EY
BCBS NC
NC
01
1437130184
BLUE CROSS BLUE SHIELD
TX
05
207763803
TX
05
279791701
FL
05
89129EY
NC
01
930113588
RAILROAD MEDICARE
NC
01
P00838042
MEDICARE RAILROAD
TX
Enumeration date
11/09/2005
Last updated
04/27/2017
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