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Individual
SHELDON SIMON
Active
Individual
SHELDON SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
07000335A
IN
213E00000X
Podiatrist
Primary
119
KY
213ES0000X
Sports Medicine Podiatrist
00119
KY
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045182
ANTHEM
KY
05
—
100027980A
—
IN
05
—
45803004
—
KY
05
—
80001191
—
KY
05
—
90270307
—
KY
Enumeration date
12/02/2005
Last updated
10/06/2015
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