Provider Demographics
NPI:1578690350
Name:SHULER, JIMMIE BLAKE (MD)
Entity Type:Individual
Prefix:DR
First Name:JIMMIE
Middle Name:BLAKE
Last Name:SHULER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-0647
Mailing Address - Country:US
Mailing Address - Phone:910-483-7337
Mailing Address - Fax:910-483-0648
Practice Address - Street 1:2501 S MEBANE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-6235
Practice Address - Country:US
Practice Address - Phone:336-228-7337
Practice Address - Fax:336-222-0293
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2016-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC26470208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1578690350Medicaid
NC3645665OtherCOVENTRY NATIONAL - COVENTRY PPO
NC1241187OtherWELLPATH
NC233112OtherMEDCOST, LLC
NC5744106OtherAETNA
NC12800373OtherPHCS-MULTIPLAN
NC1578690350OtherHEALTHSMART
NC76052OtherBLUECROSS AND BLUESHIELD
NC1241187OtherCOVENTRY OF THE CAROLINAS
NC8976052Medicaid
NCFH1101635OtherFIRST CAROLINA CARE
NC1578690350OtherHEALTHNET FEDERAL SERVICES
NC1578690350OtherHUMANA
NC1578690350OtherDOCTORS DIRECT
NC5718038OtherGREATWEST/CIGNA
NC679436OtherUNITED HEALTHCARE