Provider Demographics
NPI:1699858761
Name:SHUMWAY, PAUL D (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:SHUMWAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 N ARIZONA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-7160
Mailing Address - Country:US
Mailing Address - Phone:480-831-6772
Mailing Address - Fax:480-831-0091
Practice Address - Street 1:3120 N ARIZONA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7160
Practice Address - Country:US
Practice Address - Phone:480-831-6772
Practice Address - Fax:480-831-0091
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4177111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ4177Medicare ID - Type Unspecified