Basic Information
| Provider Information | |||||||||
| NPI: | 1629087358 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHINDEL | ||||||||
| FirstName: | STUART | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 295 STONER AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211575662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108481818 | ||||||||
| FaxNumber: | 4108763156 | ||||||||
| Practice Location | |||||||||
| Address1: | 295 STONER AVE | ||||||||
| Address2: | #102 | ||||||||
| City: | WESTMINSTER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211575698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108481818 | ||||||||
| FaxNumber: | 4108763156 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 04/25/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | D0064316 | MD | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 411448500 | 05 | MD | MEDICAID |