Individual
BENJAMIN D SHADLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 MEDICAL PLAZA, SUITE 200, ROSEVILLE, CA 95661
(916) 773-8750
(916) 773-7963
Mailing address
10470 OLD PLACERVILLE ROAD, SUITE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A99595
CA
Other
Enumeration date
11/09/2005
Last updated
10/19/2016
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