Provider Demographics
NPI:1003346545
Name:SHUMWAY, CLAY BRYANT (DPM)
Entity Type:Individual
Prefix:DR
First Name:CLAY
Middle Name:BRYANT
Last Name:SHUMWAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6682 S CODY LN
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-2020
Mailing Address - Country:US
Mailing Address - Phone:215-990-5975
Mailing Address - Fax:
Practice Address - Street 1:3584 W 9000 S STE 301
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-5711
Practice Address - Country:US
Practice Address - Phone:801-255-8633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11926746-0501213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery