Healthcare Provider Details

I. General information

NPI: 1477556678
Provider Name (Legal Business Name): SHELLY J. TEMPERLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 ARBOR AVE
MONROE MI
48162-3102
US

IV. Provider business mailing address

1404 ARBOR AVE
MONROE MI
48162-3102
US

V. Phone/Fax

Practice location:
  • Phone: 734-915-1376
  • Fax: 740-294-5627
Mailing address:
  • Phone: 734-915-1376
  • Fax: 740-294-5627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4301051963
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301051963
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: