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Individual
KELLY DEAN SHRUM
Active
Individual
KELLY DEAN SHRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
E0704
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136791003
—
AR
01
—
18424000000
QUALCHOICE
AR
Enumeration date
01/23/2006
Last updated
03/26/2026
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