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1326498551

NPI Code Detail

MEDICARE: DR. SARAH FREDERICK SHELTON MD

MEDICARE: DR. SARAH FREDERICK SHELTON MD

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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	2018025921	MO
2	208000000X	Pediatrics Physician	2018025921	MO
3	208M00000X	Hospitalist Physician	2018025921	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326498551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH FREDERICK SHELTON MD

Provider Business Mailing Address
First Line	:	1 CHILDRENS PL
Second Line	:	MSC 8515-87-1200
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1002
Country	:	US
Telephone Number	:	314-454-2076
Fax Number	:	314-747-8953

Provider Business Practice Location Address
First Line	:	2500 NE NEFF RD
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6015
Country	:	US
Telephone Number	:	541-706-4925
Fax Number	:	541-706-6813

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

Provider Enumeration Date	:	06/19/2016
Last Update Date	:	06/01/2026

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Directions to “ DR. SARAH FREDERICK SHELTON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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