Dr. Gary Michael Shellerud
Periodontist
508 W 6th Ave Ste 208
Spokane
, Washington 99204-2730
Dr. Gary Michael Shellerud
Periodontist
508 W 6th Ave Ste 208
Spokane
, Washington 99204-2730
(509) 467-2407
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Gary Michael Shellerud
- 4309 E Silver Spur Ln
- Spokane, WA
- Zip : 99217-9321
- Phone : (509) 467-2407
Second Address
- Dr. Gary Michael Shellerud
- 508 W 6th Ave Ste 208
- Spokane, WA
- Zip : 99204-2730
- Fax : (509) 838-4618
- Phone : (509) 838-4321
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 00005678 | WA |
National Provider Identifier
| NPI | 1124163068 |
|---|---|
| Provider Name | Dr. Gary Michael Shellerud |
| First Address | Spokane, WA 99217-9321 |
| Second Address | Spokane, WA 99204-2730 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/02/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.