Individual
THERESA B. SHUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14535 JOHN MARSHALL HIGHWAY, SUITE #105, GAINESVILLE, VA 20155
(703) 754-0425
(703) 754-2888
Mailing address
14535 JOHN MARSHALL HIGHWAY, SUITE #105, GAINESVILLE, VA 20155
(703) 754-0425
(703) 754-2888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101058775
VA
207Q00000X
Family Medicine Physician
0101058776
VA
Other
Enumeration date
07/27/2005
Last updated
11/21/2011
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