Healthcare Provider Details

I. General information

NPI: 1750921136
Provider Name (Legal Business Name): ERIC MATTHEW SHELMAN CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7286 S PIERCE CT
LITTLETON CO
80128-4516
US

IV. Provider business mailing address

7286 S PIERCE CT
LITTLETON CO
80128-4516
US

V. Phone/Fax

Practice location:
  • Phone: 319-759-4346
  • Fax:
Mailing address:
  • Phone: 319-759-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number172771
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: