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NPI Code Detail

MEDICARE: DONALD SHELL M.D., M.A.

MEDICARE: DONALD SHELL M.D., M.A.
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
1207Q00000XFamily Medicine PhysicianD40343MD
2207QS0010XSports Medicine (Family Medicine) PhysicianD40343MD

General Provider Information

NPI Number : 1134355050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD SHELL M.D., M.A.
Provider Business Mailing Address
First Line : 1701 MCCORMICK DR
Second Line : SUITE 200
City : LARGO
State : MD
Zip : 20774-5329
Country : US
Telephone Number : 301-883-7834
Fax Number : 301-883-7896
Provider Business Practice Location Address
First Line : 1701 MCCORMICK DR
Second Line : SUITE 200
City : LARGO
State : MD
Zip : 20774-5329
Country : US
Telephone Number : 301-883-7834
Fax Number : 301-883-7896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2009
Last Update Date : 06/05/2009

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