Individual
NELSON EUGENE SHREVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 SAINT ELIZABETH BLVD STE 4000, O FALLON, IL 62269-1284
(618) 233-5480
(618) 222-4792
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 233-7880
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036165768
IL
207Q00000X
Family Medicine Physician
2021030583
MO
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036165768
IL
Other
Enumeration date
04/09/2019
Last updated
06/26/2024
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