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Individual

SHANE ELLISON BELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1371 CHURCH STREET EXT NE STE 200, MARIETTA, GA 30060-7913
(678) 931-8091
Mailing address
1551 JANMAR RD, SNELLVILLE, GA 30078-5606
(678) 344-8900

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
12133
GA
363AS0400X
Surgical Physician Assistant
Primary
12133
GA

Other

Enumeration date
02/05/2024
Last updated
10/23/2025
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