Individual ProviderRussell ShultsAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address111 Colchester Ave, Burlington, VT 05401-1473(802) 847-0000(865) 322-0874PECOS EnrollmentBased on the most recent information from CMS, provider Russell Shults is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1083060073Provider TypeIndividualFull NameShults, RussellCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/9/2016Last Updated10/22/2020Contact InformationPractice LocationPractice Address111 Colchester Ave, Burlington, VT 05401-1473Phone(802) 847-0000FaxUnlisted FaxMailing LocationMailing Address600 Moorland Dr, Johnson City, TN 37604-4424Phone(865) 322-0874FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense042-0014896VermontCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerVermont