| David Shelley, MD | |
|
98 Poplar St, Blackfoot, ID 83221-1758 | |
| (208) 785-4100 | |
| (208) 782-3713 |
| Full Name | David Shelley |
|---|---|
| Gender | Male |
| Speciality | Interventional Radiology |
| Experience | 31 Years |
| Location | 98 Poplar St, Blackfoot, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386685535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0204X | Radiology - Vascular & Interventional Radiology | M-10024 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bingham Memorial Hospital | Blackfoot, ID | Hospital |
| Swedish American Hospital | Rockford, IL | Hospital |
| Portneuf Medical Center | Pocatello, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bmh Inc | 8426149758 | 124 |
| Swedishamerican Hospital | 5799698346 | 332 |
| Entity Name | Bmh Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255539193 PECOS PAC ID: 8426149758 Enrollment ID: O20071018000897 |
| Mailing Address | Practice Location Address |
|---|---|
| David Shelley, MD 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 785-4100 | David Shelley, MD 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 785-4100 |
Dr. David Reed Condie, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 Fax: 210-292-3760 | |
Jean Marc Cardinal, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-3810 |