Provider Demographics
NPI:1407829328
Name:SHUMAN, JOANNA G (DPM)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:G
Last Name:SHUMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21475 RIDGETOP CIR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6580
Mailing Address - Country:US
Mailing Address - Phone:703-421-1900
Mailing Address - Fax:703-433-5006
Practice Address - Street 1:21475 RIDGETOP CIR
Practice Address - Street 2:SUITE 210
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6580
Practice Address - Country:US
Practice Address - Phone:703-421-1900
Practice Address - Fax:703-433-5006
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300920213EP1101X, 213ER0200X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
U99056Medicare UPIN
VA190000949Medicare PIN