Provider Demographics
NPI:1649667478
Name:CULLUM, SHELBRA
Entity type:Individual
Prefix:
First Name:SHELBRA
Middle Name:
Last Name:CULLUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 MARKS CHURCH RD STE A
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2472
Mailing Address - Country:US
Mailing Address - Phone:706-310-8441
Mailing Address - Fax:706-230-4120
Practice Address - Street 1:1911 ALAN AVE
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-9484
Practice Address - Country:US
Practice Address - Phone:803-439-3077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management