Provider Demographics
NPI:1770699480
Name:SHELMET, JOHN JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:SHELMET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BUILDING 2B SUITE 104
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2206
Mailing Address - Country:US
Mailing Address - Phone:609-896-8050
Mailing Address - Fax:609-896-3053
Practice Address - Street 1:3131 PRINCETON PIKE
Practice Address - Street 2:BUILDING 2B SUITE 104
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2206
Practice Address - Country:US
Practice Address - Phone:609-896-8050
Practice Address - Fax:609-896-3053
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04251000207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
0828142009OtherCIGNA
0045282OtherAETNA
SH152363Medicare ID - Type Unspecified
0828142009OtherCIGNA