CHARLES RAYMOND SHIDEMAN (NPI# 1841466026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841466026 |
| Entity Type | Individual |
| Full Name | CHARLES RAYMOND SHIDEMAN |
| Credential | M.D., PH.D. |
| Practice Address |
640 Jackson St Saint Paul MN 55101-2502 |
| Mailing Address |
7401 Metro Blvd Ste 210 Edina MN 55439-3086 |
| Practice Telephone | 6512542039 |
| Practice Fax Number | 6512549333 |
| Mailing Telephone | 9529204915 |
| Mailing Fax Number | 9529156098 |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2017-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
54992 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | NPI | 1841466026 | 01 |
| Street Address |
640 JACKSON ST |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55101-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780686378 | Margaret Radermacher Schnobrich | Nurse Anesthetist, Certified Registered | 640 Jackson St, Saint Paul, MN 55101-2502 | 2005-08-12 |
| 1013518174 | Katara Jo Henderson | Student in an Organized Health Care Education/Training Program | 640 Jackson St, Saint Paul, MN 55101-2595 | 2020-11-05 |
| 1013516087 | Marit Sonnesyn | Physician Assistant | 640 Jackson St, Saint Paul, MN 55101-2502 | 2020-10-21 |
| 1114526027 | Carolyn Besch | Occupational Therapist | 640 Jackson St, Saint Paul, MN 55101-2595 | 2020-10-21 |
| 1952908576 | Mckenna Rebecca Splett | Physical Therapist | 640 Jackson St, Saint Paul, MN 55101-2502 | 2020-10-06 |
| 1164029997 | Alyssa Jean Cutcher | Physical Therapist | 640 Jackson St, Saint Paul, MN 55101-2595 | 2020-10-05 |
| 1851998884 | Danielle Chirhart | Occupational Therapist | 640 Jackson St, Saint Paul, MN 55101-2595 | 2020-10-02 |
| 1174130389 | Frederick Schaefer Jr. | Speech-Language Pathologist | 640 Jackson St, Saint Paul, MN 55101-2502 | 2020-09-30 |
| 1538775853 | Rebeca Joy Houle | Nurse Anesthetist, Certified Registered | 640 Jackson St, Saint Paul, MN 55101-2502 | 2020-09-22 |
| 1134733702 | Nicholas Honda | Pharmacist | 640 Jackson St, Saint Paul, MN 55101-2502 | 2020-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508480427 | El Solutions LLC | Clinic/Center | 445 Minnesota St., Ste. 1500 12, St. Paul, MN 55101 | 2020-06-05 |
| 1689211443 | Siripa Min | Nurse Anesthetist, Certified Registered | 640 Jackson Street Mail Stop 11503, St. Paul, MN 55101 | 2019-11-28 |
| 1922590488 | Diane Mcleod | Physician Assistant | Healthpartners Regions Specialty Clinics, 640 Jackson St - Mail Stop 11109e, Saint Paul, MN 55101 | 2018-05-31 |
| 1699284919 | Eric Mcgillis | Emergency Medicine | Regions Hospital - Emergency Medicine, 11102f, 640 Jackson St, St Paul, MN 55101 | 2017-09-29 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1992182323 | Theresa Annette Cashdollar-powell | Social Worker | 640 Jackson, St Paul, MN 55101 | 2015-05-06 |
| 1770986101 | Margaret Augusta Cutter | Physician Assistant | 200 Univeristy Ave E, Saint Paul, MN 55101 | 2014-09-30 |
| 1851641419 | Lisa Rae Caturia | Occupational Therapy Assistant | 640 Jackson St, 8th Floor, St Paul, MN 55101 | 2012-09-11 |
| 1558619478 | Rph On The Go | Community/Behavioral Health | 172 E 6th Street, 704, Saint Paul, MN 55101 | 2012-08-27 |
| 1184994212 | Duyen Truong | Pharmacist | 604 Jackson Street, St. Paul, MN 55101 | 2012-01-05 |
| Find all providers in zip 55101 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124082136 | Janel A Cox | Radiology | 631 Goodrich Ave, Saint Paul, MN 55105-3522 | 2006-04-14 |
| 1770123697 | Minnesota Oncology Hematology, Pa | Radiology | 1580 Beam Ave, Saint Paul, MN 55109-1127 | 2020-01-08 |
| 1598305427 | Minnesota Oncology Hematology, Pa | Radiology | 345 Sherman St Ste 100, Saint Paul, MN 55102-2401 | 2020-01-08 |
| 1396181731 | Ryan Schaefer Youland | Radiology | 345 Sherman St Ste 100, Saint Paul, MN 55102 | 2013-05-13 |
| 1114978335 | Kathryn E. Farniok | Radiology | 345 Sherman St, Saint Paul, MN 55102-2401 | 2006-05-12 |
| 1588633838 | Mark A Palmer | Radiology | 345 Sherman St, Suite 100, Saint Paul, MN 55102-2401 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669031423 | Kai Jiang | Radiology | 617 4th St Sw Apt 3, Rochester, MN 55902-3286 | 2019-06-06 |
| 1508205311 | Somu Suppiah | Radiology | 6500 Excelsior Blvd Dept Of, St Louis Park, MN 55426 | 2013-06-14 |
| 1063858769 | Sumit Sean Sood | Radiology | 5160 Fairview Blvd Ste 1100, Wyoming, MN 55092-8050 | 2013-05-21 |
| 1831535863 | Megan Gentry Hodges | Radiology | 1900 Centracare Circle #1600, Centracare Clinic Health Plaza Radiology/oncology, St Cloud, MN 56303-5000 | 2013-05-16 |
| 1679838403 | Richard Lee | Radiology | 701 Park Ave # G1, Minneapolis, MN 55415-1623 | 2012-07-09 |
| 1396909404 | James Lee Ecker | Radiology | 10448 Vera Cruz Dr N, Brooklyn Park, MN 55443-2555 | 2008-07-17 |
| 1275627820 | Xin Wang | Radiology | The Center for Prostate Cancer, 420 Delaware Street Se, Mayo Building, Fourth Floor, Minneapolis, MN 55455 | 2006-10-03 |
| 1295759009 | Gregory Evan Meyers | Radiology | 6950 France Ave S Ste 200, Edina, MN 55435-2025 | 2006-07-26 |
| 1770526188 | Nathan Earl Hilton | Radiology | 215 Ivy St, Brainerd, MN 56401-3000 | 2006-06-14 |
| 1952378044 | Ellen E Bellairs | Radiology | 1580 Beam Ave, Maplewood, MN 55109-1127 | 2006-03-07 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55101 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.