Individual
MR. KALUB GERRARD SHIPMAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1719 BRISTOL RD, GREENSBORO, NC 27406-3854
(336) 327-7976
(336) 271-2155
Mailing address
1719 BRISTOL RD, GREENSBORO, NC 27406-3854
(336) 327-7976
(336) 271-2155
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HC1786
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409116
—
NC
05
—
6600648
—
NC
Enumeration date
01/05/2007
Last updated
07/09/2007
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