Provider Demographics
NPI:1265403521
Name:SHUMAN, MARTIN L (OD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:L
Last Name:SHUMAN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-1158
Mailing Address - Country:US
Mailing Address - Phone:781-233-5544
Mailing Address - Fax:781-231-9634
Practice Address - Street 1:200 WALNUT ST
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-1158
Practice Address - Country:US
Practice Address - Phone:781-233-5544
Practice Address - Fax:781-231-9634
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2177152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW15135OtherBCBSMA
MA0327433Medicaid
MASH428958Medicare ID - Type Unspecified