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General NPI Number Information
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NPI Number | 1720028913
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Entity Type | Individual
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Provider Name | JAMES EDWARD SHADBOLT DPM
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 2200 PUMP RD STE 227
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City | HENRICO
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State | VA
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Zip | 23233
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Country | US
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Telephone | 804-754-7400
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Fax | 804-754-7402
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Provider Business Mailing Address
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Address Line | 110 N ROBINSON ST SUITE 100
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City | RICHMOND
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State | VA
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Zip | 23220-4459
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Country | US
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Telephone | 804-359-0569
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Fax | 804-359-0875
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 0103000832
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License Number State | VA
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