Individual
SHADE R WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2115 N KANSAS, CHILDREN & ADOLESCENT CLINIC PC, HASTINGS, NE 68901
(402) 463-6828
(402) 463-4767
Mailing address
2115 N KANSAS, CHILDREN & ADOLESCENT CLINIC PC, HASTINGS, NE 68901
(402) 463-6828
(402) 463-4767
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23753
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47063717813
—
NE
Enumeration date
08/12/2006
Last updated
01/19/2012
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