Provider Demographics
NPI:1275618092
Name:SHIPMAN, DENISE (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SHIPMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1670 CLIFTON ROAD
Mailing Address - Street 2:VAMC - MHSL
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033
Mailing Address - Country:US
Mailing Address - Phone:404-321-6111
Mailing Address - Fax:706-291-3753
Practice Address - Street 1:4015 SOUTH COBB DR
Practice Address - Street 2:SUITE 5
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080
Practice Address - Country:US
Practice Address - Phone:770-333-9633
Practice Address - Fax:770-333-3309
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2014-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0392342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G38755Medicare UPIN
GA26BDJGFMedicare ID - Type Unspecified