=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033433040
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET LENORA SHIRLEY MS, MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2010
-----------------------------------------------------
Last Update Date | 05/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 192 FOX HOLE RUN
-----------------------------------------------------
City | PISGAH FOREST
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-971-3730
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 192 FOX HOLE RUN
-----------------------------------------------------
City | PISGAH FOREST
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28768-9177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-971-3730
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 12345567
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 2024-00803
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------