Individual
SHELLEY BUNDY STANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
175 CITY HILL DR, LONDON, KY 40741-3037
(606) 877-2050
(606) 877-2080
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38962
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64091309
—
KY
01
—
CB8799
RR MEDICARE GROUP
KY
01
—
P00145375
RR MEDICARE PIN
KY
Enumeration date
07/24/2006
Last updated
06/17/2025
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