| Charles Raymond Shideman, MD, PHD | |
|
640 Jackson St, Saint Paul, MN 55101-2502 | |
| (651) 254-2039 | |
| (651) 254-9333 |
| Full Name | Charles Raymond Shideman |
|---|---|
| Gender | Male |
| Speciality | Radiation Oncology |
| Experience | 18 Years |
| Location | 640 Jackson St, Saint Paul, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841466026 | NPI | - | NPPES |
| 1841466026 | Other | MN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 54992 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Regions Hospital | Saint paul, MN | Hospital |
| Lakeview Memorial Hospital | Stillwater, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Minneapolis Radiation Oncology Pa | 8527951094 | 18 |
| Minneapolis Radiation Oncology Pa | 8527951094 | 18 |
| Entity Name | Minneapolis Radiation Oncology Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043204233 PECOS PAC ID: 8527951094 Enrollment ID: O20040206000831 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Raymond Shideman, MD, PHD 7401 Metro Blvd Ste 210, Edina, MN 55439-3086 Ph: (952) 920-4915 | Charles Raymond Shideman, MD, PHD 640 Jackson St, Saint Paul, MN 55101-2502 Ph: (651) 254-2039 |
Joseph H Tashjian, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 166 4th St E, Saint Paul, MN 55101 Phone: 651-292-2043 Fax: 651-292-2204 | |
Dr. Lorraine Laroy, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 250 Thompson St, Saint Paul, MN 55102 Phone: 651-292-2000 Fax: 651-292-2136 | |
Dr. Paul Robert Oler Ii, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 250 Thompson St, Saint Paul, MN 55102 Phone: 651-292-2000 | |
Christopher A Jackson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 166 4th St E, Saint Paul, MN 55101 Phone: 651-292-2043 Fax: 651-292-2204 | |
Mckinley Cribbs Lawson, M.D., PH.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 250 Thompson St, Saint Paul, MN 55102 Phone: 651-292-2000 | |
Kathryn E. Farniok, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 345 Sherman St, Saint Paul, MN 55102 Phone: 651-251-5500 Fax: 651-251-5555 | |
Dr. Janel A Cox, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 631 Goodrich Ave, Saint Paul, MN 55105 Phone: 651-224-4255 |