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Individual
MR. GROVER ALEXANDER SHELTON III
Active
Individual
MR. GROVER ALEXANDER SHELTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
429527
OH
363L00000X
Nurse Practitioner
Primary
71008853A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300023898
—
IN
Enumeration date
11/09/2018
Last updated
10/20/2020
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