Provider Demographics
NPI:1043316821
Name:SHELL, DAN HUFF III (MD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:HUFF
Last Name:SHELL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1068 CRESTHAVEN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-0845
Mailing Address - Country:US
Mailing Address - Phone:901-761-4844
Mailing Address - Fax:901-761-6929
Practice Address - Street 1:1068 CRESTHAVEN RD STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0845
Practice Address - Country:US
Practice Address - Phone:901-761-4844
Practice Address - Fax:901-761-6929
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD133492086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3186141Medicaid
B58863Medicare UPIN
3186142Medicare ID - Type Unspecified