Provider Demographics
NPI:1871871327
Name:ROSS-SHELTON, CARRIE (MD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:ROSS-SHELTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21000 BROOKPARK RD
Mailing Address - Street 2:MS 15-5
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135
Mailing Address - Country:US
Mailing Address - Phone:216-433-5841
Mailing Address - Fax:216-433-6529
Practice Address - Street 1:21000 BROOKPARK RD
Practice Address - Street 2:MS 15-5
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-3127
Practice Address - Country:US
Practice Address - Phone:216-433-5841
Practice Address - Fax:216-433-6529
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0471552083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine