Provider Demographics
NPI:1629241757
Name:SHAMBAUGH, JAMES PHILIP JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILIP
Last Name:SHAMBAUGH
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 L ST NW
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5002
Mailing Address - Country:US
Mailing Address - Phone:202-452-0060
Mailing Address - Fax:202-966-2691
Practice Address - Street 1:1900 L ST NW
Practice Address - Street 2:SUITE 204
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5002
Practice Address - Country:US
Practice Address - Phone:202-452-0060
Practice Address - Fax:202-966-2691
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH17576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor