Healthcare Provider Details

I. General information

NPI: 1033433040
Provider Name (Legal Business Name): MARGARET LENORA SHIRLEY MS, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2010
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 FOX HOLE RUN
PISGAH FOREST NC
28768
US

IV. Provider business mailing address

192 FOX HOLE RUN
PISGAH FOREST NC
28768-9177
US

V. Phone/Fax

Practice location:
  • Phone: 415-971-3730
  • Fax:
Mailing address:
  • Phone: 415-971-3730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number12345567
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2024-00803
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: