Individual
SHADE RAYMOND PRESTON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1350 WALTON WAY, AUGUSTA, GA 30901-2612
(706) 737-9250
(706) 733-0697
Mailing address
1824 WALTON WAY, AUGUSTA, GA 30904-3804
(706) 737-9250
(706) 733-0697
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
058811
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
058811
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159750664A
—
GA
05
—
G58811
—
SC
01
—
P00424799
RAILROAD MEDICARE
GA
Enumeration date
03/29/2007
Last updated
06/16/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us