Provider Demographics
NPI:1881696037
Name:SHELTON, STUART D (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:D
Last Name:SHELTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 40908
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-0908
Mailing Address - Country:US
Mailing Address - Phone:910-615-6448
Mailing Address - Fax:910-439-0936
Practice Address - Street 1:2109 VALLEYGATE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3682
Practice Address - Country:US
Practice Address - Phone:910-609-3636
Practice Address - Fax:910-435-0936
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600730207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8973945Medicaid
NCG29234Medicare UPIN
NC8973945Medicaid
NC2226950BMedicare PIN