Basic Information
Provider Information
NPI: 1760126601
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHROPSHIRE
FirstName: BEATRIZ
MiddleName: CARRIE
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PEDIATRIC EDUCATION OFFICE CAMPUS BOX 7593
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275990001
CountryCode: US
TelephoneNumber: 9199663172
FaxNumber: 9199668419
Practice Location
Address1: 301 E WENDOVER AVE STE 400
Address2:  
City: GREENSBORO
State: NC
PostalCode: 274011207
CountryCode: US
TelephoneNumber: 3368323150
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/26/2022
LastUpdateDate: 06/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X NCY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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