Individual
DALE R SHOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 271-1423
Mailing address
PO BOX 2746, FARGO, ND 58108-2746
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
3700
ND
2085N0700X
Neuroradiology Physician
3700
ND
2085N0904X
Nuclear Radiology Physician
3700
ND
2085P0229X
Pediatric Radiology Physician
3700
ND
2085R0202X
Diagnostic Radiology Physician
Primary
3700
ND
2085R0204X
Vascular & Interventional Radiology Physician
3700
ND
2085U0001X
Diagnostic Ultrasound Physician
3700
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025063500
—
MN
05
—
12366
—
ND
05
—
1992123
—
IA
01
—
49703SH
BC/BS
MN
01
—
SHO000698
BC/BS OF ND
ND
Enumeration date
07/22/2006
Last updated
05/20/2008
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