Basic Information
| Provider Information | |||||||||
| NPI: | 1194943316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHIPE | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | GARMAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 INDUSTRIAL RD STE 5 | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017573736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084731480 | ||||||||
| FaxNumber: | 5084731210 | ||||||||
| Practice Location | |||||||||
| Address1: | 94 MENDON ST | ||||||||
| Address2: | |||||||||
| City: | HOPEDALE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017471311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084825401 | ||||||||
| FaxNumber: | 5084825402 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 04/18/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101249007 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 250331 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 250331 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.