Individual
DAVID SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
(208) 782-3713
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
(208) 782-3713
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
M-10024
ID
Other
Enumeration date
06/09/2006
Last updated
09/27/2010
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