Individual
DR. JASON KIMBALL SHELLNUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1121 CROOKS RD, ROYAL OAK, MI 48067-1301
(248) 541-8554
(248) 541-1791
Mailing address
1121 CROOKS RD, ROYAL OAK, MI 48067-1301
(248) 541-8554
(248) 541-1791
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R-6999
IA
Other
Enumeration date
10/05/2006
Last updated
03/23/2017
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