Provider Demographics
NPI:1417036856
Name:SHULMAN, IRA M (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:M
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:333 NW 70TH AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2385
Mailing Address - Country:US
Mailing Address - Phone:954-792-5750
Mailing Address - Fax:954-581-0567
Practice Address - Street 1:333 NW 70TH AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2385
Practice Address - Country:US
Practice Address - Phone:954-792-5750
Practice Address - Fax:954-581-0567
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 22186207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2000960OtherAETNA
FL591659416OtherBLUE CROSS BLUE SHIELD
FL372126400Medicaid
FLD58351Medicare UPIN
FL372126400Medicaid