Individual
BLYNN L SHIDELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., P.C.
Contact information
Practice address
576 HARTNELL ST, SUITE 200, MONTEREY, CA 93940-2833
(425) 996-1001
(206) 600-5033
Mailing address
1420 NW GILMAN BLVD, SUITE 2-2786, ISSAQUAH, WA 98027-5394
(425) 996-1001
(206) 600-5033
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G23099
CA
208600000X
Surgery Physician
MD00045810
WA
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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