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Individual

DARREL BRUCE SHELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4233 GATEWAY BLVD, NEWBURGH, IN 47630-8900
(812) 426-9510
(812) 426-9518
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 426-9510
(812) 426-9518

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01031181A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000109395
ANTHEM
IN
05
100145050
IN
01
64756182
KY MEDICAID
KY
Enumeration date
12/04/2006
Last updated
01/09/2013
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