Provider Demographics
NPI:1679659932
Name:SHINKLE, BRIAN WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WILLIAM
Last Name:SHINKLE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:501 W 14TH ST
Mailing Address - Street 2:OCCUPATIONAL HEALTH SERVICES, WILMINGTON HOSP. 1ST FLR
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1013
Mailing Address - Country:US
Mailing Address - Phone:302-428-4250
Mailing Address - Fax:302-428-4280
Practice Address - Street 1:501 W 14TH ST
Practice Address - Street 2:OCCUPATIONAL HEALTH SERVICES, WILMINGTON HOSP. 1ST FLR
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1013
Practice Address - Country:US
Practice Address - Phone:302-428-4250
Practice Address - Fax:302-428-4280
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2012-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS-013176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI35769Medicare UPIN