Provider Demographics
NPI:1336103746
Name:SHOEMAKER, GEORGE J (DC)
Entity Type:Individual
Prefix:MRS
First Name:GEORGE
Middle Name:J
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3384 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-3450
Mailing Address - Country:US
Mailing Address - Phone:610-865-6111
Mailing Address - Fax:610-865-6111
Practice Address - Street 1:3384 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-3450
Practice Address - Country:US
Practice Address - Phone:610-865-6111
Practice Address - Fax:610-865-6111
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002077-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030862OtherASHN
PA02596300OtherBLUE CROSS
PA350032233OtherRAILROAD MEDICARE
PAP1017719OtherOXFORD HEALTH PLAN
PA143949OtherBLUE SHIELD
PA204724001OtherCIGNA
PA1030862OtherASHN
PASH143949Medicare PIN