Provider Demographics
NPI:1740263193
Name:SHUMAN, VICTORIA L (DO)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:L
Last Name:SHUMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1464 JEFFERSON ST N
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-1380
Mailing Address - Country:US
Mailing Address - Phone:304-645-3220
Mailing Address - Fax:844-479-4545
Practice Address - Street 1:1464 JEFFERSON ST N
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-1380
Practice Address - Country:US
Practice Address - Phone:304-645-3220
Practice Address - Fax:844-479-4545
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV1610207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2116304OtherALLIANCE PROV #
WV5630042000Medicaid
WV080149146OtherRAILROAD MEDICARE #
WVWV01610OtherHEALTH PLAN #
WV001718908OtherBLUECROSSBLUESHIELD #
WV5116317OtherMAMSI PROV IDER #
WV206318OtherCARELINK/COVENTRY #
WV0846392Medicare PIN
WV7260141Medicare PIN
WV2116304OtherALLIANCE PROV #