Individual
ANGELA MARIE SHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Mailing address
48498 MATTAPANY RD, LEXINGTON PARK, MD 20653-3507
(240) 496-9568
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
247200000X
MD
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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