Provider Demographics
NPI:1801524285
Name:SHUMATE, RYAN MATTHEW
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:MATTHEW
Last Name:SHUMATE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2286 RITTER DR
Mailing Address - Street 2:
Mailing Address - City:DANIELS
Mailing Address - State:WV
Mailing Address - Zip Code:25832-9397
Mailing Address - Country:US
Mailing Address - Phone:304-237-5585
Mailing Address - Fax:681-207-7212
Practice Address - Street 1:2286 RITTER DR
Practice Address - Street 2:
Practice Address - City:DANIELS
Practice Address - State:WV
Practice Address - Zip Code:25832-9397
Practice Address - Country:US
Practice Address - Phone:304-237-5585
Practice Address - Fax:681-207-7212
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist