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General NPI Number Information
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NPI Number | 1164935631
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Entity Type | Organization
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Legal Business Name | CORNELL J SHELTON MD PLLC
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 10401 SPOTSYLVANIA AVE
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-8606
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Country | US
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Telephone | 540-741-3786
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Fax |
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Provider Business Mailing Address
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Address Line | 5746 UNION MILL RD # 157
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City | CLIFTON
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State | VA
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Zip | 20124-1088
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Country | US
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Telephone | 703-272-7444
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | CORNELL SHELTON
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Credential |
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Telephone | 413-222-5925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | VA
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