Healthcare Provider Details

I. General information

NPI: 1760458194
Provider Name (Legal Business Name): SHELLY R. STELZER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2006
Last Update Date: 11/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE. UVM MEDICAL CENTER, DEPT. OF ANESTHESIA
BURLINGTON VT
05401
US

IV. Provider business mailing address

111 COLCHESTER AVE. UVM MEDICAL CENTER, DEPT. OF ANESTHESIA
BURLINGTON VT
05401
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-2415
  • Fax: 802-847-5324
Mailing address:
  • Phone: 802-847-2415
  • Fax: 802-847-5324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME92475
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number042.0011176
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: