Provider Demographics
NPI:1114132230
Name:SHADID, BETSY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:BETSY
Middle Name:ANN
Last Name:SHADID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BETSY
Other - Middle Name:ANN
Other - Last Name:CIARIMBOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13820 WIRELESS WAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2501
Mailing Address - Country:US
Mailing Address - Phone:405-471-4047
Mailing Address - Fax:405-330-5611
Practice Address - Street 1:13820 WIRELESS WAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-2501
Practice Address - Country:US
Practice Address - Phone:405-471-4047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK250972084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry