Provider Demographics
NPI:1013038074
Name:KELLEY, SHEILA PHELPS (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:PHELPS
Last Name:KELLEY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 ROUSSEAU DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-4116
Mailing Address - Country:US
Mailing Address - Phone:585-872-2049
Mailing Address - Fax:
Practice Address - Street 1:1112 ROUSSEAU DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-4116
Practice Address - Country:US
Practice Address - Phone:585-872-2049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine