Provider Demographics
NPI:1922299387
Name:SHUMWAY, BRIAN SPENCER (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:SPENCER
Last Name:SHUMWAY
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:SCHOOL OF DENTISTRY 501 PRESTON STREET
Mailing Address - Street 2:SURGICAL AND HOSPITAL DENTISTRY RM 337
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40292-0001
Mailing Address - Country:US
Mailing Address - Phone:502-852-5083
Mailing Address - Fax:502-852-5988
Practice Address - Street 1:SCHOOL OF DENTISTRY 501 SOUTH PRESTON STREET
Practice Address - Street 2:FACULTY PRACTICE, SUITE 334
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40292-0001
Practice Address - Country:US
Practice Address - Phone:502-852-5401
Practice Address - Fax:502-852-7602
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
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Provider Licenses
StateLicense IDTaxonomies
KY85481223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology