Healthcare Provider Details

I. General information

NPI: 1760460893
Provider Name (Legal Business Name): PAUL F. SCHELLHAMMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 CLEARFIELD AVE
VA BEACH VA
23462-1815
US

IV. Provider business mailing address

225 CLEARFIELD AVE
VA BEACH VA
23462-1815
US

V. Phone/Fax

Practice location:
  • Phone: 757-442-6050
  • Fax: 757-961-3696
Mailing address:
  • Phone: 757-442-6050
  • Fax: 757-961-3696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101025375
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: