Individual
BEAU J SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 UNIVERSITY OF NEW MEXICO # 105600, ALBUQUERQUE, NM 87131-0001
(505) 272-4107
(505) 272-8098
Mailing address
1 UNIVERSITY OF NEW MEXICO # 105600, ALBUQUERQUE, NM 87131-0001
(505) 272-4107
(505) 272-8098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA180086
OR
363A00000X
Physician Assistant
Primary
PA2018-0087
NM
Other
Enumeration date
10/06/2016
Last updated
10/23/2024
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