Basic Information
| Provider Information | |||||||||
| NPI: | 1558333518 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHELVER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2610 E UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852138436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808928400 | ||||||||
| FaxNumber: | 4808929533 | ||||||||
| Practice Location | |||||||||
| Address1: | 2149 W 24TH ST | ||||||||
| Address2: | |||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853646136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287264120 | ||||||||
| FaxNumber: | 9283410315 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2006 | ||||||||
| LastUpdateDate: | 10/17/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WX1100X | 23288 | AZ | Y | Nursing Service Providers | Registered Nurse | Ophthalmic |
No ID Information.