Individual
DR. SHELLEY A KATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5400 CANYON BLUFF TRL NE, ALBUQUERQUE, NM 87111-8239
(505) 508-1029
Mailing address
5400 CANYON BLUFF TRL NE, ALBUQUERQUE, NM 87111-8239
(505) 508-1029
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
SK078965
MI
390200000X
Student in an Organized Health Care Education/Training Program
RS2012-0788
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024544
MIDWEST HEALTH PLAN
MI
01
—
0P23930
MICHIGAN MEDICARE PLUS BL
MI
05
—
104932923
—
MI
01
—
1108140971
BCBS OF MICHIGAN PIN
MI
01
—
142240
PREFERRED CHOICES
MI
01
—
17388
M-CARE HMO
MI
01
—
562533142
HARVARD PILGRIM NATIONAL
MI
01
—
6U4933
HEALTH ALLIANCE PLAN HMO
MI
01
—
A4238872
AETNA PLANS
MI
01
—
RS2012-0788
LICENSE NUMBER
NM
01
—
SK078965
MICHIGAN STATE LICENSE
MI
Enumeration date
11/15/2005
Last updated
11/20/2012
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