Provider Demographics
NPI:1609969310
Name:SHOUMER, ALBERT (DPM)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:SHOUMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 S. DUNDALK AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21222
Mailing Address - Country:US
Mailing Address - Phone:410-282-6434
Mailing Address - Fax:410-284-4636
Practice Address - Street 1:40 S. DUNDALK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222
Practice Address - Country:US
Practice Address - Phone:410-282-6434
Practice Address - Fax:410-284-4636
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00392213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT59845Medicare UPIN
MDT147AMedicare ID - Type UnspecifiedMEDICARE