Individual
CHARLES H SHELTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
187 SKYLAR DR, LEWISBURG, WV 24901-9359
(304) 425-1960
(304) 487-3514
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
19802
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437192630
—
VA
05
—
7200011000
—
WV
01
—
P00716522
RR MEDICARE
WV
Enumeration date
06/14/2006
Last updated
04/18/2013
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