Individual
MR. LEE THOMAS SHUPING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MPT
Contact information
Practice address
1807 FORDHAM BLVD, CHAPEL HILL, NC 27514-2200
(984) 974-9747
(984) 974-9786
Mailing address
1807 FORDHAM BLVD, CHAPEL HILL, NC 27514-2200
(984) 974-9747
(984) 974-9786
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0116023402
VA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2015-00533
NC
225100000X
Physical Therapist
10443
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067X8
BLUE CROSS
NC
05
—
7212079
—
NC
Enumeration date
03/27/2007
Last updated
10/26/2017
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