Provider Demographics
NPI:1578781860
Name:SHIPLEY, SARAH H (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:H
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HEUN
Other - Middle Name:JIN
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:629 D LOWTHER ROAD
Mailing Address - Street 2:
Mailing Address - City:LEWISBERRY
Mailing Address - State:PA
Mailing Address - Zip Code:17339-9527
Mailing Address - Country:US
Mailing Address - Phone:717-932-5200
Mailing Address - Fax:717-932-3095
Practice Address - Street 1:629 D LOWTHER ROAD
Practice Address - Street 2:
Practice Address - City:LEWISBERRY
Practice Address - State:PA
Practice Address - Zip Code:17339-9527
Practice Address - Country:US
Practice Address - Phone:717-932-5200
Practice Address - Fax:717-932-3095
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP000902085R0202X
PAMD4404152085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024891900001Medicaid
MD419962600Medicaid
MD419962600Medicaid