Provider Demographics
NPI:1588811277
Name:MASTER, JOLIE HAMILTON SHIMP (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOLIE
Middle Name:HAMILTON SHIMP
Last Name:MASTER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-1308
Mailing Address - Country:US
Mailing Address - Phone:856-769-9400
Mailing Address - Fax:
Practice Address - Street 1:303 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08098-1308
Practice Address - Country:US
Practice Address - Phone:856-769-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00297400213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist