Kelly, Shaunda Elyse

Kelly, Shaunda Elyse is an individual health care provider with primary practice located at 2000 6Th Ave S , Birmingham AL 35233-2110. She recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as her primary health care specialty. Kelly, Shaunda Elyse can be contacted via phone (205) 934-9999.

Contact Information

Primary practice address
2000 6Th Ave S Birmingham AL 35233-2110
Phone: (205) 934-9999
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 5395 Alabama

Profile Details

NPI number 1659540508
LBN Legal business name Kelly, Shaunda Elyse
Credentials MD, DMD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2008
Last updated Mar 14th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659540508 NPPES
Alabama Other 051118224 BCBS
Alabama MEDICAID 130496 BCBS
Alabama Other Z17060 BCBS
Alabama MEDICAID 130492 BCBS
Alabama MEDICAID 01281210 BCBS
Alabama MEDICAID 130497 BCBS
Alabama Other 051118219 BCBS
Alabama Other 051118223 BCBS
Alabama Other 051118226 BCBS
Alabama MEDICAID 130494 BCBS
Alabama Other 051118221 BCBS
Alabama MEDICAID 130495 BCBS

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