Provider Demographics
NPI:1356483630
Name:SHELDON, STEVE RANDALL (DC)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:RANDALL
Last Name:SHELDON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1306
Mailing Address - Country:US
Mailing Address - Phone:248-813-7777
Mailing Address - Fax:248-813-7770
Practice Address - Street 1:6455 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1306
Practice Address - Country:US
Practice Address - Phone:248-813-7777
Practice Address - Fax:248-813-7770
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISS005102111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition