Healthcare Provider Details

I. General information

NPI: 1396372033
Provider Name (Legal Business Name): MICHAEL ALAN SHELTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COLCHESTER AVE
BURLINGTON VT
05401-1473
US

IV. Provider business mailing address

202 LANDINGS POINTE LN
WARNER ROBINS GA
31088-6656
US

V. Phone/Fax

Practice location:
  • Phone: 802-847-0000
  • Fax:
Mailing address:
  • Phone: 831-241-0862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number103697
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: