MEDICARE: CHARLES S SHELDON D.O.

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	207R00000X	Internal Medicine Physician	34003664	OH

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	:	1568465425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES S SHELDON D.O.

Provider Business Mailing Address
First Line	:	2200 JEFFERSON AVE FL 5
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-7102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2213 CHERRY ST UNIT 2B
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2603
Country	:	US
Telephone Number	:	419-251-5155
Fax Number	:	419-251-5160

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/14/2020

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