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General NPI Number Information
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NPI Number | 1942203823
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Entity Type | Individual
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Provider Name | RALPH EDWARD SHRIDER MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 01/23/2014
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Provider Practice Location Address
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Address Line | 274 E CHICAGO ST
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City | COLDWATER
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State | MI
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Zip | 49036-2041
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Country | US
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Telephone | 517-279-5400
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Fax | 517-279-1247
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Provider Business Mailing Address
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Address Line | 5700 SOUTHWYCK BLVD
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City | TOLEDO
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State | OH
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Zip | 43614-1509
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Country | US
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Telephone | 800-288-8325
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Fax | 419-866-5453
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301051638
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License Number State | MI
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