Individual
DR. IAN S SHUPACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7571 COLD HARBOR RD, MECHANICSVILLE, VA 23111-1631
(804) 746-9055
(804) 746-4476
Mailing address
7571 COLD HARBOR RD, MECHANICSVILLE, VA 23111-1631
(804) 746-9055
(804) 746-4476
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101054440
VA
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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