Individual
DR. SHELBY KEVIN SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 BROOKLYN AVE, BROOKLYN, NY 11213-1908
(718) 498-7888
(718) 604-7890
Mailing address
PO BOX 391, WHITE PLAINS, NY 10602-0391
(718) 498-7888
(718) 604-7890
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
176352
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01448966
—
NY
Enumeration date
07/20/2006
Last updated
02/10/2012
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