Individual
DR. MARK A SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822
(570) 271-6408
(570) 271-5845
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
172506
NY
207RI0200X
Infectious Disease Physician
172506
NY
207RI0200X
Infectious Disease Physician
Primary
MD463888
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01143939
—
NY
Enumeration date
08/07/2006
Last updated
08/31/2020
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