Provider Demographics
NPI:1134313380
Name:SHOEMAKER, DAVID VERLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:VERLE
Last Name:SHOEMAKER
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 1:515 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-3129
Mailing Address - Country:US
Mailing Address - Phone:907-252-8887
Mailing Address - Fax:785-579-6481
Practice Address - Street 1:12647 OLIVE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6346
Practice Address - Country:US
Practice Address - Phone:314-744-4223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA290103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical