MEDICARE: DR. STEVEN ROBERT SHELTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD13798	OR

General Provider Information

NPI Number	:	1184716540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN ROBERT SHELTON M.D.

Provider Business Mailing Address
First Line	:	2575 CENTER ST NE
Second Line	:	DOC HEALTH SERVICES
City	:	SALEM
State	:	OR
Zip	:	97301-4600
Country	:	US
Telephone Number	:	503-378-5530
Fax Number	:	503-378-5597

Provider Business Practice Location Address
First Line	:	2575 CENTER ST NE
Second Line	:	DOC HEALTH SERVICES
City	:	SALEM
State	:	OR
Zip	:	97301-4600
Country	:	US
Telephone Number	:	503-378-5530
Fax Number	:	503-378-5597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/08/2007

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