Provider Demographics
NPI:1760460893
Name:SCHELLHAMMER, PAUL F (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:SCHELLHAMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CLEARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1815
Mailing Address - Country:US
Mailing Address - Phone:757-442-6050
Mailing Address - Fax:757-961-3696
Practice Address - Street 1:225 CLEARFIELD AVE
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1815
Practice Address - Country:US
Practice Address - Phone:757-442-6050
Practice Address - Fax:757-961-3696
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101025375208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA331818OtherANTHEM BC BS
VA007501595Medicaid
VA52623OtherSENTARA HEALTHCARE
B06259Medicare UPIN
VA007501595Medicaid
VA52623OtherSENTARA HEALTHCARE