Provider Demographics
NPI:1275321416
Name:SHALTOUT, YOUSR (MD)
Entity type:Individual
Prefix:DR
First Name:YOUSR
Middle Name:
Last Name:SHALTOUT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BRIDGE ST
Mailing Address - Street 2:STE 201
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541
Mailing Address - Country:US
Mailing Address - Phone:434-799-4488
Mailing Address - Fax:434-773-6977
Practice Address - Street 1:109 BRIDGE ST
Practice Address - Street 2:STE 201
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541
Practice Address - Country:US
Practice Address - Phone:434-799-4488
Practice Address - Fax:434-773-6977
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116040264207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine