Provider Demographics
NPI:1053077214
Name:SHAMBUGER, JANELL
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:
Last Name:SHAMBUGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6951 DICKENS FERRY RD APT 35
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-4464
Mailing Address - Country:US
Mailing Address - Phone:251-545-4882
Mailing Address - Fax:
Practice Address - Street 1:6951 DICKENS FERRY RD APT 35
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-4464
Practice Address - Country:US
Practice Address - Phone:251-545-4882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier