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NPI Code Detail

MEDICARE: DR. SUSAN CATHERINE SHELLEY MD

MEDICARE: DR. SUSAN CATHERINE SHELLEY MD
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
1208000000XPediatrics Physician29403SC

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 : 1952515603
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN CATHERINE SHELLEY MD
Provider Business Mailing Address
First Line : 29 MEADOW SPRINGS LN
Second Line :
City : GREER
State : SC
Zip : 29650-1005
Country : US
Telephone Number : 864-360-7773
Fax Number :
Provider Business Practice Location Address
First Line : 975 W FARIS RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-4241
Country : US
Telephone Number : 864-729-8330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 04/07/2026

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