Provider Demographics
NPI:1528414547
Name:SHUM, ANDREW MEYER (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MEYER
Last Name:SHUM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2109 WEST ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3837
Mailing Address - Country:US
Mailing Address - Phone:901-754-6020
Mailing Address - Fax:901-754-9882
Practice Address - Street 1:2109 WEST ST
Practice Address - Street 2:SUITE #1
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3837
Practice Address - Country:US
Practice Address - Phone:901-754-6020
Practice Address - Fax:901-754-9882
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2016-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN3317152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist