Individual
DR. MICHELLE D SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2120 RIETH BLVD STE A, GOSHEN, IN 46526
(574) 875-5126
(574) 875-1874
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01049433A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200205160
—
IN
Enumeration date
03/01/2006
Last updated
04/28/2023
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