Basic Information
| Provider Information | |||||||||
| NPI: | 1417166851 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARRETT-ALBAUGH | ||||||||
| FirstName: | SHELI | ||||||||
| MiddleName: | RUTH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 311 EMERYWOOD DR | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285579610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522474297 | ||||||||
| FaxNumber: | 2522477383 | ||||||||
| Practice Location | |||||||||
| Address1: | 3511 JOHN PLATT DR | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285574321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522474792 | ||||||||
| FaxNumber: | 2522477383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 01/17/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 2245 | WV | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 2011-00707 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 5918560 | 05 | NC | MEDICAID | 1417166851 | 01 | NC | NPI | OTHER |