Provider Demographics
NPI:1952480345
Name:SHIPLEY, DOROTHY (PT)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 TIDEWATER COLONY DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2592
Mailing Address - Country:US
Mailing Address - Phone:410-266-8010
Mailing Address - Fax:443-782-2498
Practice Address - Street 1:2001 TIDEWATER COLONY DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2592
Practice Address - Country:US
Practice Address - Phone:410-266-8010
Practice Address - Fax:443-782-2498
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2777855OtherCAREFIRST BLUE SHIELD
MH277855OtherMAMSI HEALTH CARE
MDS441003OtherCAREFIRST BLUE CHOICE
MD7691439OtherAETNA HEALTH CARE
MH277855OtherMAMSI HEALTH CARE
MDP84335Medicare UPIN