Provider Demographics
NPI:1528186301
Name:DON SHUMWAY D P M PC
Entity Type:Organization
Organization Name:DON SHUMWAY D P M PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHUMWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:928-536-4253
Mailing Address - Street 1:1083 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SNOWFLAKE
Mailing Address - State:AZ
Mailing Address - Zip Code:85937-5582
Mailing Address - Country:US
Mailing Address - Phone:928-536-4253
Mailing Address - Fax:928-536-5942
Practice Address - Street 1:1083 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:SNOWFLAKE
Practice Address - State:AZ
Practice Address - Zip Code:85937-5582
Practice Address - Country:US
Practice Address - Phone:928-536-4253
Practice Address - Fax:928-536-5942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0538213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ85740Medicare PIN