Provider Demographics
NPI:1487689469
Name:SHELDON, MICHAEL S (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:SHELDON
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:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58108-6001
Mailing Address - Country:US
Mailing Address - Phone:701-364-3300
Mailing Address - Fax:701-364-8906
Practice Address - Street 1:1702 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4940
Practice Address - Country:US
Practice Address - Phone:701-364-3300
Practice Address - Fax:701-364-8906
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND7444207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND0402549OtherMEDICA #
ND0404040OtherMEDICA #
ND14064OtherNDBS #
NDHP22974OtherHEALTHPARTNERS #
ND598775OtherAMERICA'S PPO/ARAZ #
ND18809Medicaid
ND142064OtherUCARE #
ND15640OtherSIOUX VALLEY #
NDDA9011015586OtherPREFERRED ONE #
NDND100011OtherLHS #
ND977016000Medicaid
ND33T91SHOtherMNBS #
ND33T91SHOtherMNBS #
ND33T91SHOtherMNBS #
ND977016000Medicaid