Shelley, Mark H

Shelley, Mark H is an individual health care provider with primary practice located at 1 Willow St , Port Allegany PA 16743-1332. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shelley, Mark H can be contacted via phone (814) 642-9531.

Contact Information

Primary practice address
1 Willow St Port Allegany PA 16743-1332
Phone: (814) 642-9531
Fax: (814) 642-2020
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD029656E Pennsylvania

Profile Details

NPI number 1336106954
LBN Legal business name Shelley, Mark H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Nov 24th, 2010 - about 16 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 1336106954 NPPES
Pennsylvania MEDICAID 001403288001
Pennsylvania Other 75710
Pennsylvania Other 080023500

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