Provider Demographics
NPI:1992960918
Name:SHELTON, SARAH MELISSA (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MELISSA
Last Name:SHELTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:MELISSA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:940 NE 13TH ST
Mailing Address - Street 2:2G-2300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5008
Mailing Address - Country:US
Mailing Address - Phone:405-271-2429
Mailing Address - Fax:405-271-2421
Practice Address - Street 1:940 NE 13TH ST
Practice Address - Street 2:2G-2300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5008
Practice Address - Country:US
Practice Address - Phone:405-271-2429
Practice Address - Fax:405-271-2421
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26396208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics