Organization
SHELBY PATHOLOGY GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM R SHIPLEY MD (PRESIDENT)
(704) 487-1955
Entity
Organization
Contact information
Practice address
201 E GROVER ST, SHELBY, NC 28150-3917
(704) 487-1955
(704) 487-1975
Mailing address
PO BOX 1268, SHELBY, NC 28151-1268
(704) 487-1955
(704) 487-1975
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02640
BLUE CROSS BLUE SHIELD OF
NC
05
—
6902640
—
NC
Enumeration date
07/03/2006
Last updated
01/30/2008
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