Individual
WALTER SHELTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1001 SAM PERRY BLVD, MARY WASHINGTON HOSPITAL, FREDERICKSBURG, VA 22401-4453
(540) 741-7614
(540) 741-7615
Mailing address
3676 BILLINGS ST, MT PLEASANT, SC 29466-6888
(904) 557-8561
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024166332
VA
367500000X
Certified Registered Nurse Anesthetist
AA083444
ME
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP1859212
FL
367500000X
Certified Registered Nurse Anesthetist
RN172500
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000531601
MEDICARE - MDIH
ME
05
—
301633100
—
FL
01
—
430068749
RAILROAD RETIREMENT
—
05
—
550353313B
—
GA
01
—
G2936
BC/BS FL
FL
Enumeration date
05/04/2006
Last updated
06/16/2015
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