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MR. GROVER ALEXANDER SHELTON III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
8075 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46250
(317) 621-8500
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7588

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
429527
OH
363L00000X
Nurse Practitioner
Primary
71008853A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300023898
IN
Enumeration date
11/09/2018
Last updated
10/20/2020
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