Shellito, Paul Clarke
Shellito, Paul Clarke is an sole proprietor health care provider with primary practice located at 15 Parkman St Wac 460, Boston MA 02114-3117. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Shellito, Paul Clarke can be contacted via phone (617) 724-0365.Contact Information
Primary practice address
15 Parkman St Wac 460
Boston MA 02114-3117
Phone: (617) 724-0365
Fax: (617) 724-3943
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 49343 | Massachusetts |
Profile Details
| NPI number | 1952391500 |
|---|---|
| LBN Legal business name | Shellito, Paul Clarke |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 25th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952391500 | NPPES |
| Massachusetts | MEDICAID | 6199267 | |
| Massachusetts | Other | 714301 | |
| Massachusetts | Other | E05768 |
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