Provider Demographics
NPI:1326428285
Name:IPC HOSPITALIST COMPANY
Entity Type:Organization
Organization Name:IPC HOSPITALIST COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:313-530-9188
Mailing Address - Street 1:1628 HUNTWOOD PARK CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-3998
Mailing Address - Country:US
Mailing Address - Phone:313-530-9188
Mailing Address - Fax:
Practice Address - Street 1:1628 HUNTWOOD PARK CT
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48324-3998
Practice Address - Country:US
Practice Address - Phone:313-530-9188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004921282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital