Provider Demographics
NPI:1851616676
Name:ODRONIC, SHELLEY IRENE (MD)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:IRENE
Last Name:ODRONIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:IRENE
Other - Last Name:REDFERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 636324
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6324
Mailing Address - Country:US
Mailing Address - Phone:859-301-2018
Mailing Address - Fax:859-301-2073
Practice Address - Street 1:1 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3403
Practice Address - Country:US
Practice Address - Phone:859-301-2018
Practice Address - Fax:859-301-2073
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.122255207ZP0102X
KYTP338207ZP0102X
IN01077007A207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology