Jeromy Michael Shoup
Family Doctor - Geriatric Medicine
517 N Concord Rd
Crawfordsville
, Indiana 47933-9002
Jeromy Michael Shoup
Family Doctor - Geriatric Medicine
517 N Concord Rd
Crawfordsville
, Indiana 47933-9002
(317) 517-2339
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About
Features
Specialties
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Jeromy Michael Shoup
- 2910 Gadsen Cir N
- Carmel, IN
- Zip : 46032-8392
- Phone : (317) 517-2339
Second Address
- Jeromy Michael Shoup
- 517 N Concord Rd
- Crawfordsville, IN
- Zip : 47933-9002
- Phone : (317) 517-2339
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QG0300X | Family Doctor - Geriatric Medicine | 28215271A | IN |
National Provider Identifier
| NPI | 1053960120 |
|---|---|
| Provider Name | Jeromy Michael Shoup |
| First Address | Carmel, IN 46032-8392 |
| Second Address | Crawfordsville, IN 47933-9002 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/09/2019 |
| Last Update Date | 10/09/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.