Individual
MR. DOUGLAS JAMES SHADLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
425 CROSS ST, SUITE 116, PUNTA GORDA, FL 33950-4872
(941) 639-4248
(941) 639-8002
Mailing address
425 CROSS ST, SUITE 116, PUNTA GORDA, FL 33950-4872
(941) 639-4248
(941) 639-8002
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
ME76084
FL
2084P0800X
Psychiatry Physician
ME76084
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME76084
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD19739
HLTH PROF QUAL ASSURANCE
WA
01
—
ME76084
DEPT OF HEALTH
FL
Enumeration date
07/31/2006
Last updated
09/11/2025
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