MEDICARE: DR. HUNTER GABEL SHELTON DO

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	390200000X	Student in an Organized Health Care Education/Training Program		NC

General Provider Information

NPI Number	:	1295438497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUNTER GABEL SHELTON DO

Provider Business Mailing Address
First Line	:	ATRIUM HEALTH WAKE FOREST BAPTIST DEPT. OF PSYCHIATRY
Second Line	:	ONE MEDICAL CENTER BOULEVARD
City	:	WINSTON-SALEM
State	:	NC
Zip	:	27157-1087
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	ATRIUM HEALTH WAKE FOREST BAPTIST DEPT. OF PSYCHIATRY
Second Line	:	ONE MEDICAL CENTER BOULEVARD
City	:	WINSTON-SALEM
State	:	NC
Zip	:	27157-1087
Country	:	US
Telephone Number	:	336-716-4551
Fax Number	:	336-716-9642

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

Provider Enumeration Date	:	03/24/2023
Last Update Date	:	03/24/2023

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