Provider Demographics
NPI:1285054486
Name:SHELTON, THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:SHELTON
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-0879
Mailing Address - Country:US
Mailing Address - Phone:301-744-9024
Mailing Address - Fax:
Practice Address - Street 1:6537 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4268
Practice Address - Country:US
Practice Address - Phone:301-744-9024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-27
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557166111N00000X
MDS03778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor