Provider Demographics
NPI:1659360899
Name:MCKEE, SHELLEY G (MD)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:G
Last Name:MCKEE
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 1:97 LIBBEY INDUSTRIAL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:EAST WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3110
Mailing Address - Country:US
Mailing Address - Phone:781-331-3300
Mailing Address - Fax:781-337-8356
Practice Address - Street 1:97 LIBBEY INDUSTRIAL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:EAST WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3110
Practice Address - Country:US
Practice Address - Phone:781-331-3300
Practice Address - Fax:781-337-8356
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52562207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6175384Medicaid
B74367Medicare UPIN
MAJ03111Medicare ID - Type Unspecified