Provider Demographics
NPI:1184252934
Name:OWENS, SHELBY MARIE (MD)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:MARIE
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 EXPLORER ST
Mailing Address - Street 2:
Mailing Address - City:GWINN
Mailing Address - State:MI
Mailing Address - Zip Code:49841-2813
Mailing Address - Country:US
Mailing Address - Phone:906-481-8586
Mailing Address - Fax:906-372-3230
Practice Address - Street 1:945 9TH ST
Practice Address - Street 2:
Practice Address - City:LAKE LINDEN
Practice Address - State:MI
Practice Address - Zip Code:49945-1100
Practice Address - Country:US
Practice Address - Phone:906-483-1030
Practice Address - Fax:906-372-3230
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301510204207Q00000X, 207Q00000X
MN69648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine