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NPI Code Detail

MEDICARE: SHELLY CLELAND CAMPBELL

MEDICARE: SHELLY CLELAND CAMPBELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1730711573
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLY CLELAND CAMPBELL
Provider Business Mailing Address
First Line : 4000 WELLNESS DR
Second Line :
City : MIDLAND
State : MI
Zip : 48670-2000
Country : US
Telephone Number : 844-832-1956
Fax Number : 989-633-5241
Provider Business Practice Location Address
First Line : 3051 KIESEL RD
Second Line :
City : BAY CITY
State : MI
Zip : 48706-2449
Country : US
Telephone Number : 989-778-2888
Fax Number : 989-778-2887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2020
Last Update Date : 03/03/2026

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Directions to “ SHELLY CLELAND CAMPBELL ” Practice Location

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