Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | AZ0538 | AZ |
Y | 222Z00000X | Podiatrist | AZ0538 | AZ |
NPI | 1023080405 |
---|---|
Provider Name | Don A Shumway |
First Address | Snowflake, AZ 85937-5582 |
Second Address | Snowflake, AZ 85937-5582 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 22/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
589335 | (05) | AZ |
U90203 | (02) |