NPI 1356430607 · live from the CMS NPI Registry
Shibu Philip, MD
Internal Medicine, Cardiovascular Disease in Fayetteville, GA. National Provider Identifier 1356430607, active.
NPI record
| NPI | 1356430607 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Cardiovascular Disease 207RC0000X |
| Practice location | 1267 Highway 54 W Ste 2200, Fayetteville, GA 30214 |
| Practice phone | 770-716-0051 |
| Mailing address | Po Box 751803, Charlotte, NC 28275 |
| Enumerated | October 12, 2006 |
| Last updated | May 16, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Cardiovascular Disease | 207RC0000X | 0101279895 (VA) |
| Internal Medicine, Cardiovascular Disease | 207RC0000X | 2012-02030 (NC) |
| Internal Medicine, Cardiovascular Disease primary | 207RC0000X | 98806 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.