MEDICARE: DR. RODNEY SHOLTY M.D.

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	207Q00000X	Family Medicine Physician	20140	HI
2	207Q00000X	Family Medicine Physician	PENDING	OR

General Provider Information

NPI Number	:	1356735823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODNEY SHOLTY M.D.

Provider Business Mailing Address
First Line	:	13745 CAYO GORDA CT
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78418-6301
Country	:	US
Telephone Number	:	702-888-2067
Fax Number	:

Provider Business Practice Location Address
First Line	:	8121 CARAMEL GORGE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143
Country	:	US
Telephone Number	:	702-888-2067
Fax Number	:

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

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	08/02/2023

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Directions to “ DR. RODNEY SHOLTY M.D.” Practice Location

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