Provider Demographics
NPI:1386652105
Name:SHELTON, KAREN PATRICIA (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:PATRICIA
Last Name:SHELTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:PATRICIA
Other - Last Name:SEYMORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO, MHA
Mailing Address - Street 1:418 HWY 58 NORTH
Mailing Address - Street 2:PO BOX 216
Mailing Address - City:TRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:28585
Mailing Address - Country:US
Mailing Address - Phone:252-448-9111
Mailing Address - Fax:252-448-1443
Practice Address - Street 1:418 NC HIGHWAY 58 N
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NC
Practice Address - Zip Code:28585-9530
Practice Address - Country:US
Practice Address - Phone:252-448-9111
Practice Address - Fax:252-448-1443
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200600612207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC200600612OtherLICENSE NO FOR NC MEDICAL
NC5903819Medicaid
NC5903819Medicaid