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Individual
CAROLE E SHELLEY
Active
Individual
CAROLE E SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
31911
AZ
207V00000X
Obstetrics & Gynecology Physician
Primary
M-10122
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77366
BLUE CROSS OF IDAHO
ID
05
—
808067800
—
ID
01
—
82-0503971
RAILROAD-MEDICARE
ID
05
—
829335
—
AZ
Enumeration date
10/25/2005
Last updated
07/19/2012
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