Provider Demographics
NPI:1801046818
Name:SHUMARD, TODD A (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:SHUMARD
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 1:200 HERITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3146
Mailing Address - Country:US
Mailing Address - Phone:406-756-3950
Mailing Address - Fax:406-756-3957
Practice Address - Street 1:200 HERITAGE WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3146
Practice Address - Country:US
Practice Address - Phone:406-756-3950
Practice Address - Fax:406-756-3957
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT194382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry