Provider Demographics
NPI:1558425272
Name:RICE, SHELLEY (MD)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:WILSON
Other - Last Name:WROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:40 MEDICINE CIRCLE BLUE ZONE ROOM 3688
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-668-7215
Mailing Address - Fax:
Practice Address - Street 1:40 MEDICINE CIRCLE BLUE ZONE ROOM 3688
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-668-7215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC99-00730207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G96878Medicare ID - Type Unspecified
NC2277220AMedicare ID - Type Unspecified
NC891217HMedicare ID - Type Unspecified