Individual
SHELLY STEPHENS GROENENDYK
Active
Individual
SHELLY STEPHENS GROENENDYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
10516430-1205
UT
207L00000X
Anesthesiology Physician
Primary
329018
NY
207L00000X
Anesthesiology Physician
63603
TN
Other
Enumeration date
05/10/2016
Last updated
11/03/2024
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