Provider Demographics
NPI:1659014017
Name:SHUMATE, JOHN NICHOLAS JUNG (MD)
Entity Type:Individual
Prefix:
First Name:JOHN NICHOLAS
Middle Name:JUNG
Last Name:SHUMATE
Suffix:
Gender:M
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:BIDMC HARVARD PSYCHIATRY RESIDENCY TRAINING PROGRAM
Mailing Address - Street 2:330 BROOKLINE AVENUE, RABB-2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-7000
Mailing Address - Fax:
Practice Address - Street 1:BIDMC HARVARD PSYCHIATRY RESIDENCY TRAINING PROGRAM
Practice Address - Street 2:330 BROOKLINE AVENUE, RABB-2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-667-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program