| NPI | 1932324712 |
|---|---|
| Doing Business As | SHIDELER DERMATOLOGY AND SKIN CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | STEPHEN SHIDELER Owner 317-846-2396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IN 1025166) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2010-06-22 |