# DR. MITCHELL LEE SHELLMAN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1851977680
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | M-17432 | ID | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | MT226019 | PA | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | CO | — |

## Other

- **Enumeration date:** 03/22/2021
- **Last updated:** 09/22/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 208D00000X | — | ID |
| 05 | — | MT226019 | — | PA |