| Shelby Internal Medicine, Inc | |
|
1413 N Lafayette St Shelby NC 28150-3406 | |
| (704) 487-4321 | |
| (704) 487-9561 |
| Full Name | Shelby Internal Medicine, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1413 N Lafayette St, Shelby, North Carolina |
| Authorized Official Name and Position | Ian Patrick Stamp (PRESIDENT) |
| Authorized Official Contact | 7044874321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelby Internal Medicine, Inc Po Box 1149 Shelby NC 28151-1149 Ph: (704) 487-4321 | Shelby Internal Medicine, Inc 1413 N Lafayette St Shelby NC 28150-3406 Ph: (704) 487-4321 |
| NPI Number | 1770787277 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5799757274 |
|---|---|
| Medicare Enrollment ID | O20040806000587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770787277 | NPI | - | NPPES |
| 891171E | Medicaid | NC | |
| 1171E | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ian P Stamp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912965583 PECOS PAC ID: 2567443021 Enrollment ID: I20040528001136 |
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