Provider Demographics
NPI:1215050570
Name:SCHENDEL, SHELLEY MARIE (DO)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:MARIE
Last Name:SCHENDEL
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50505 SCHOENHERR RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3140
Mailing Address - Country:US
Mailing Address - Phone:586-314-0080
Mailing Address - Fax:877-673-3562
Practice Address - Street 1:50505 SCHOENHERR RD
Practice Address - Street 2:SUITE 290
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315
Practice Address - Country:US
Practice Address - Phone:586-314-0080
Practice Address - Fax:877-673-3562
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016525207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E00425OtherBLUE CROSS BLUE SHIELD
MI1215050570Medicaid
MI0E00425OtherBLUE CROSS BLUE SHIELD