Provider Demographics
NPI:1477556678
Name:TEMPERLEY, SHELLY J (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELLY
Middle Name:J
Last Name:TEMPERLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 ARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3102
Mailing Address - Country:US
Mailing Address - Phone:734-915-1376
Mailing Address - Fax:740-294-5627
Practice Address - Street 1:1404 ARBOR AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3102
Practice Address - Country:US
Practice Address - Phone:734-915-1376
Practice Address - Fax:740-294-5627
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301051963208D00000X, 207W00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH800300OtherUHC
OHM61537OtherHPUOV
OH3415986091A11OtherBC/BS
OH822186Medicaid
OH800300OtherUHC
OHE85301Medicare UPIN