Individual
DR. JEAN E SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
721 FAIRFAX AVE, 3RD FLOOR, NORFOLK, VA 23507-2007
(757) 446-5915
(757) 446-5969
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5915
(757) 446-5969
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101027193
VA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101027193
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-017
TRICARE/CHAMPUS
VA
05
—
006833608
—
VA
01
—
053788
ANTHEM
VA
01
—
0674V
BC/BS
NC
01
—
10007084
SENTARA/OPTIMA DAY REHAB
—
01
—
15740
SENTARA
VA
01
—
215224
UHC/MAMSI
—
05
—
890674V
—
NC
01
—
PAR
VIRGINIA PREMIER HEALTH
VA
Enumeration date
03/22/2006
Last updated
01/04/2011
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