Basic Information
| Provider Information | |||||||||
| NPI: | 1346216090 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHELTON | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 149 MAIN ST | ||||||||
| Address2: | STE 2A | ||||||||
| City: | WINTHROP | ||||||||
| State: | ME | ||||||||
| PostalCode: | 043641486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076243800 | ||||||||
| FaxNumber: | 2076243845 | ||||||||
| Practice Location | |||||||||
| Address1: | 149 MAIN ST | ||||||||
| Address2: | STE 2A | ||||||||
| City: | WINTHROP | ||||||||
| State: | ME | ||||||||
| PostalCode: | 043641486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076243800 | ||||||||
| FaxNumber: | 2076243845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 03/04/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 16286 | ME | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 416980099 | 05 | ME | MEDICAID |