Provider Demographics
NPI:1558333518
Name:SHELVER, DAVID G (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:SHELVER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 E UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-8436
Mailing Address - Country:US
Mailing Address - Phone:480-892-8400
Mailing Address - Fax:480-892-9533
Practice Address - Street 1:2149 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6136
Practice Address - Country:US
Practice Address - Phone:928-726-4120
Practice Address - Fax:928-341-0315
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23288163WX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX1100XNursing Service ProvidersRegistered NurseOphthalmic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ102698Medicare PIN
AZZ102695Medicare PIN
AZZ102696Medicare PIN
AZZ102694Medicare PIN
AZZ102697Medicare PIN
AZR09595Medicare UPIN