Provider Demographics
NPI:1740272301
Name:SHOEMAKER, RITCHIE CARR (MD)
Entity type:Individual
Prefix:
First Name:RITCHIE
Middle Name:CARR
Last Name:SHOEMAKER
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 1:500 MARKET ST
Mailing Address - Street 2:SUITE 102,103
Mailing Address - City:POCOMOKE
Mailing Address - State:MD
Mailing Address - Zip Code:21851-1170
Mailing Address - Country:US
Mailing Address - Phone:410-957-1550
Mailing Address - Fax:410-957-3930
Practice Address - Street 1:500 MARKET ST
Practice Address - Street 2:SUITE 102,103
Practice Address - City:POCOMOKE
Practice Address - State:MD
Practice Address - Zip Code:21851-1170
Practice Address - Country:US
Practice Address - Phone:410-957-1550
Practice Address - Fax:410-957-3930
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD24924170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7757RCMedicare ID - Type Unspecified
MDD77284Medicare UPIN