Provider Demographics
NPI:1932425329
Name:KELLY, SHAWN C (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:C
Last Name:KELLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 6010
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59406-6010
Mailing Address - Country:US
Mailing Address - Phone:406-731-8888
Mailing Address - Fax:406-731-8876
Practice Address - Street 1:1300 28TH ST S FL 2
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5296
Practice Address - Country:US
Practice Address - Phone:406-455-4320
Practice Address - Fax:406-455-4977
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2023-04-05
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Provider Licenses
StateLicense IDTaxonomies
MT67556207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology