Individual
DR. SHELLSEA PORTILLO CANALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
CENTER FOR SPECIALIZED MEDICINE 1225 S GRAND BLVD, SECOND FLOOR, SAINT LOUIS, MO 63104-1016
(314) 257-8000
Mailing address
743 N PARK ST, SAINT LOUIS, MO 63119-1907
(929) 523-3782
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2023022535
MO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2023022535
MO
Other
Enumeration date
08/14/2020
Last updated
07/09/2025
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