Provider Demographics
NPI:1710195235
Name:SHILLER, SHIRLEY MICHELLE (DO)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:MICHELLE
Last Name:SHILLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:MICHELLE
Other - Last Name:SHILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSPT
Mailing Address - Street 1:1010 AIRPARK CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-5200
Mailing Address - Country:US
Mailing Address - Phone:615-221-4447
Mailing Address - Fax:
Practice Address - Street 1:1010 AIRPARK CENTER DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-5200
Practice Address - Country:US
Practice Address - Phone:615-562-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3877207ZP0102X
MN104899207ZP0102X
TXN6661207ZP0102X
MN53466207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MNENROLLEDMedicaid