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General NPI Number Information
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NPI Number | 1609976448
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Entity Type | Individual
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Provider Name | DR. MARGARET SHELLY
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1755 COMMONWEALTH AVE
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City | BRIGHTON
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State | MA
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Zip | 02135-4040
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Country | US
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Telephone | 617-254-5611
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Fax | 617-782-6363
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Provider Business Mailing Address
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Address Line | 1755 COMMONWEALTH AVE
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City | BRIGHTON
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State | MA
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Zip | 02135-4040
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Country | US
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Telephone | 617-254-5611
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Fax | 617-782-6363
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 46666
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License Number State | MA
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