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Individual
CHRISTOPHER SHACKLEFORD
Active
Individual
CHRISTOPHER SHACKLEFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5151015252
MI
207RN0300X
Nephrology Physician
Primary
OT023189
PA
Other
Enumeration date
06/02/2021
Last updated
06/24/2024
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