Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | RT005621 | PA |
Y | 213ES0000X | Sports Medicine | RT005621 | PA |
NPI | 1417468919 |
---|---|
Provider Name | James Sheldon |
First Address | Stroudsburg, PA 18360-1934 |
Second Address | East Stroudsburg, PA 18301-2956 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2017 |
Last Update Date | 24/10/2017 |