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CHARLES RAYMOND SHIDEMAN M.D., PH.D.

Individual Provider (NPI-1) Active

Provider Information

NPI Number
1841466026
Provider Type
Individual Provider (NPI-1)
Credentials
M.D., PH.D.
Status
Active

Contact & Location

Address
640 JACKSON ST, SAINT PAUL, MN, 551012502
Phone
(651) 254-2039
Fax
(651) 254-9333

Specialties & Taxonomies

Unknown Primary License: MN #54992

All Addresses

MAILING

7401 METRO BLVD STE 210

EDINA, MN, 554393086

(952) 920-4915

LOCATION

640 JACKSON ST

SAINT PAUL, MN, 551012502

(651) 254-2039