Provider Demographics
NPI:1073142238
Name:SHIPMAN, WILLIAM D (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:SHIPMAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:DEWEY
Other - Last Name:SHIPMAN
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2720 W MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-3034
Mailing Address - Country:US
Mailing Address - Phone:818-842-8000
Mailing Address - Fax:818-478-7207
Practice Address - Street 1:2720 W MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505
Practice Address - Country:US
Practice Address - Phone:818-842-8000
Practice Address - Fax:818-478-7207
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA192799207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology