Individual
STEPHEN SHIMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1647 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 23511-2803
(317) 529-4292
Mailing address
304 28TH ST UNIT 307, VIRGINIA BEACH, VA 23451-3056
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9111145
UT
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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