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Individual
PENNY L. SHELTON
Active
Individual
PENNY L. SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22917
WV
207Q00000X
Family Medicine Physician
Primary
35-08-3516
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000182413
UNISON MEDICAID
OH
01
—
000000328527
ANTHEM BCBS
—
01
—
001714156
MOUNTAIN STATE BCBS
—
05
—
1811329000
—
WV
01
—
2467781
MOLINA MEDICAID
OH
05
—
2467781
—
OH
01
—
310917085132
CARESOURCE MEDICAID
OH
01
—
P00175244
RR MEDICARE
—
Enumeration date
06/08/2006
Last updated
12/04/2020
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