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Individual

STEVE MICHAEL SHELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1401 WEST RD., MCCS COMPLEX BLDG. 1231, CAMP LEJEUNE, NC 28542
(910) 451-5249
(910) 451-5381
Mailing address
1021 BEECH TREE RD, JACKSONVILLE, NC 28546-6001
(910) 451-5249
(910) 451-5381

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0999
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
093KJ
BCBS STATE/FED. PROVIDER
NC
01
7453310
AETNA PROVIDER NUMBER
NC
Enumeration date
09/07/2006
Last updated
07/09/2007
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