Provider Demographics
NPI:1528598489
Name:SHEWMAKE, ALLISON (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SHEWMAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E. MED. CTR. DR.
Mailing Address - Street 2:SPC 5718
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5718
Mailing Address - Country:US
Mailing Address - Phone:734-763-5589
Mailing Address - Fax:734-763-4802
Practice Address - Street 1:1500 E MED CTR DR
Practice Address - Street 2:SPC 5718
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5718
Practice Address - Country:US
Practice Address - Phone:734-763-5589
Practice Address - Fax:734-763-4802
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301112609208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics