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NPI Code Detail

MEDICARE: SHELBY MEDICAL ASSOCIATES, PA

MEDICARE: SHELBY MEDICAL ASSOCIATES, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RA0000XAdolescent Medicine (Internal Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104819754
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHELBY MEDICAL ASSOCIATES, PA
Provider Business Mailing Address
First Line : 711 N DEKALB ST
Second Line :
City : SHELBY
State : NC
Zip : 28150-3911
Country : US
Telephone Number : 704-482-1482
Fax Number : 704-480-6012
Provider Business Practice Location Address
First Line : 711 N DEKALB ST
Second Line :
City : SHELBY
State : NC
Zip : 28150-3911
Country : US
Telephone Number : 704-482-1482
Fax Number : 704-480-6012
Authorized Official
Title or Position : PRESIDENT/PHYSICIAN
Name : PAUL BRENT FERRELL
Credential : MD
Telephone Number : 704-482-1482
Provider Enumeration Date : 08/30/2005
Last Update Date : 03/21/2011

Similar Medicare Providers

1750011425 — DR. BRITTNEY MARIE SABOL DNP, AGPCNP-BC
Practice Location Address:
711 N DEKALB ST
SHELBY, NC
28150-3911
Practice Phone: 704-482-1482
Practice Fax:
1043203441 — KYLE ANTHONY ALDINGER MD
Practice Location Address:
711 N DEKALB ST
SHELBY, NC
28150-3911
Practice Phone: 704-482-1482
Practice Fax: 704-480-6012
1164415584 — GIDEON BESSON MD
Practice Location Address:
711 N DEKALB ST
SHELBY, NC
28150-3911
Practice Phone: 704-482-1482
Practice Fax: 704-480-6012
1316930746 — NANCY PUTNAM JOLLY ANP-C
Practice Location Address:
711 N DEKALB ST
SHELBY, NC
28150-3911
Practice Phone: 704-482-1482
Practice Fax: 704-480-6012
1093708406 — EVELYN ANGELINA RABINDRAN MD
Practice Location Address:
711 N DEKALB ST
SHELBY, NC
28150-3911
Practice Phone: 704-482-1482
Practice Fax: 704-480-6012
1275526683 — BARRY EDWARD COALSON MD
Practice Location Address:
711 N DEKALB ST
SHELBY, NC
28150-3911
Practice Phone: 704-482-1482
Practice Fax: 704-480-6012

Directions to “SHELBY MEDICAL ASSOCIATES, PA ” Practice Location

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