Provider Demographics
NPI:1881161891
Name:SHELSON, MATTHEW JAMES (ND, PHD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JAMES
Last Name:SHELSON
Suffix:
Gender:M
Credentials:ND, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 N ALMER ST
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1547
Mailing Address - Country:US
Mailing Address - Phone:855-672-2600
Mailing Address - Fax:855-672-2601
Practice Address - Street 1:21 N ALMER ST
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-1547
Practice Address - Country:US
Practice Address - Phone:855-670-2600
Practice Address - Fax:855-670-2601
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-29
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
9427488175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath