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NPI Code Detail

MEDICARE: DR. WILLIAM DUANE SHIDAL JR. M.D.

MEDICARE: DR. WILLIAM DUANE SHIDAL JR. M.D.
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 Physician01028006AIN
22085R0202XDiagnostic Radiology Physician01028006IN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2300073546OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000083926OTHERINANTHEM

General Provider Information

NPI Number : 1376663526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM DUANE SHIDAL JR. M.D.
Provider Business Mailing Address
First Line : PO BOX 445
Second Line :
City : NEW CASTLE
State : IN
Zip : 47362-0445
Country : US
Telephone Number : 765-521-1135
Fax Number : 765-521-1331
Provider Business Practice Location Address
First Line : 1000 NO. 16TH ST.
Second Line :
City : NEW CASTLE
State : IN
Zip : 47362-4319
Country : US
Telephone Number : 765-521-1135
Fax Number : 765-521-1331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 05/10/2026

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