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General NPI Number Information
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NPI Number | 1952450256
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Entity Type | Individual
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Provider Name | SHELLY CHUMBLER SPURGESS O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 6445 CITATION DR STE B
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City | CLARKSTON
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State | MI
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Zip | 48346-2996
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Country | US
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Telephone | 248-922-1862
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Fax | 248-922-2894
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Provider Business Mailing Address
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Address Line | 3522 N QUARRY CREEK DR
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City | WHITE LAKE
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State | MI
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Zip | 48383-1878
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Country | US
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Telephone | 205-329-1430
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Fax | 248-922-2894
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-B32-TA-732
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901004626
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License Number State | MI
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