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Individual

STEVEN C SHADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, ATC

Contact information

Practice address
8000 YORK RD, SPORTS MEDICINE - FIELD HOUSE 101D, TOWSON, MD 21252-0001
(410) 704-2890
Mailing address
307 LORD BYRON LN, APT. T4, COCKEYSVILLE, MD 21030-3544
(570) 772-2223

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
06/21/2007
Last updated
07/08/2007
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