Provider Demographics
NPI:1154702827
Name:BRAND, SHELLEY (DPM)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:
Last Name:BRAND
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1249
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:MS
Mailing Address - Zip Code:39367
Mailing Address - Country:US
Mailing Address - Phone:601-735-5151
Mailing Address - Fax:601-735-7244
Practice Address - Street 1:940 MATTHEW DR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:MS
Practice Address - Zip Code:39367
Practice Address - Country:US
Practice Address - Phone:601-735-7243
Practice Address - Fax:601-735-7244
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN838213E00000X
TXT55-2015213ES0103X
GAPOD001377213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery