Individual
DR. SHELLY STYONS HARKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6913 N MAIN ST, GRANGER, IN 46530-8039
(574) 647-1500
(574) 243-4310
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01076599A
IN
207Q00000X
Family Medicine Physician
036-107483
IL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
01076599A
IN
208M00000X
Hospitalist Physician
036.107483
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201394170
—
IN
Enumeration date
09/16/2005
Last updated
11/07/2016
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