Shelton, Richard Russell

Shelton, Richard Russell is an individual health care provider with primary practice located at 4095 S Lee St , Buford GA 30518-3647. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Shelton, Richard Russell can be contacted via phone (770) 932-8519.

Contact Information

Primary practice address
4095 S Lee St Buford GA 30518-3647
Phone: (770) 932-8519
Fax: (770) 533-4798
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 043775 Georgia

Profile Details

NPI number 1619947769
LBN Legal business name Shelton, Richard Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Aug 17th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619947769 NPPES
Georgia Other 302587 WELLCARE
Georgia Other 52684584 WELLCARE
Georgia Other 5402578 WELLCARE
Georgia Other 8238671 WELLCARE
Georgia MEDICAID 000754157M WELLCARE
Georgia MEDICAID 000754157P WELLCARE
Georgia MEDICAID 000754157Q WELLCARE
Georgia Other 1939869 WELLCARE
Georgia Other 302571 WELLCARE
Georgia MEDICAID 000754157N WELLCARE
Georgia MEDICAID 000754157R WELLCARE
Georgia Other 10032982 WELLCARE
Georgia Other 302567 WELLCARE
Georgia Other 2276934 WELLCARE
Georgia Other 302588 WELLCARE

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