| NPI | 1396033882 |
|---|---|
| Former Legal Business Name | BENJAMIN D. SHADLE, MD, INC. |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN DEAN SHADLE President 916-688-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A99595) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2012-05-08 |