Provider Demographics
NPI:1336196872
Name:APPLIN, SHIRELLE D (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIRELLE
Middle Name:D
Last Name:APPLIN
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 1:3170 KETTERING BLVD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3188
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:1343 N FOUNTAIN BLVD
Practice Address - Street 2:STE 250
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1422
Practice Address - Country:US
Practice Address - Phone:937-523-9050
Practice Address - Fax:937-523-9059
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075891A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00432942OtherRAILROAD MEDICARE
OH2177166Medicaid
OH4023197Medicare PIN
OHH007172Medicare PIN
OHP00432942OtherRAILROAD MEDICARE
OHH17399Medicare UPIN