Provider Demographics
NPI:1003806175
Name:SHUMAKER, DAVID M (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:SHUMAKER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PARKINGWAY
Mailing Address - Street 2:P.O. BOX 146
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1708
Mailing Address - Country:US
Mailing Address - Phone:781-974-8988
Mailing Address - Fax:781-383-1239
Practice Address - Street 1:12 PARKINGWAY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1708
Practice Address - Country:US
Practice Address - Phone:781-974-8988
Practice Address - Fax:781-383-1239
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8172103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASHW51239Medicare ID - Type Unspecified