Provider Demographics
NPI:1306720396
Name:BROWN, SHELBY MICHAEL
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:MICHAEL
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 LAKE CREST CIR APT 2B
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-7601
Mailing Address - Country:US
Mailing Address - Phone:530-216-6585
Mailing Address - Fax:
Practice Address - Street 1:1714 COMFORT ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1511
Practice Address - Country:US
Practice Address - Phone:530-216-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other