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NPI Code Detail

MEDICARE: DR. RALPH EDWARD SHRIDER MD

MEDICARE: DR. RALPH EDWARD SHRIDER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician4301051638MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13001237452OTHERMIBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942203823
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RALPH EDWARD SHRIDER MD
Provider Business Mailing Address
First Line : 5700 SOUTHWYCK BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43614-1509
Country : US
Telephone Number : 800-288-8325
Fax Number : 419-866-5453
Provider Business Practice Location Address
First Line : 274 E CHICAGO ST
Second Line :
City : COLDWATER
State : MI
Zip : 49036-2041
Country : US
Telephone Number : 517-279-5400
Fax Number : 517-279-1247
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 01/23/2014

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