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General NPI Number Information
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NPI Number | 1356435259
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Entity Type | Organization
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Legal Business Name | ROGER H.SHELLING,M.D.,P.A.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5601 N.DIXIE HIGHWAY
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City | FT.LAUDERDALE
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State | FL
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Zip | 33334
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Country | US
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Telephone | 954-772-8207
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Fax | 954-938-8056
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Provider Business Mailing Address
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Address Line | 5601 N.DIXIE HIGHWAY
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City | FT.LAUDERDALE
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State | FL
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Zip | 33334
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Country | US
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Telephone | 954-772-8207
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Fax | 954-938-8056
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Authorized Official
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Title or Position | PHYSICIAN/UROLOGIST
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Name | DR. ROGER HARRIS SHELLING
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Credential | MD
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Telephone | 954-772-8207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME0035947
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License Number State | FL
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