Individual
PETER D SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
325 MEETING HOUSE LN BLDG 2, SUITE 301, SOUTHAMPTON, NY 11968-5087
(631) 287-9477
Mailing address
325 MEETING HOUSE LN BLDG 2, SUITE 301, SOUTHAMPTON, NY 11968-5087
(631) 287-9477
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
000426 1
NY
363AS0400X
Surgical Physician Assistant
Primary
000426 2
NY
Other
Enumeration date
07/11/2006
Last updated
03/20/2008
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