Provider Demographics
NPI:1932177854
Name:SHOEMAKER, MARGRIT MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGRIT
Middle Name:MARY
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 GRAMPIAN BLVD
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 GRAMPIAN BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1909
Practice Address - Country:US
Practice Address - Phone:570-320-7848
Practice Address - Fax:570-320-7856
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032389E207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA800814OtherFIRST PRIORITY HEALTH
PAE52802OtherHEALTHAMERICA
PA0011664320003Medicaid
PA50054311OtherCAPITAL BLUE CROSS
PA556530OtherAETNA
PA802085OtherUNITEDHEALTHCARE
PA432567OtherHIGHMARK BLUE SHIELD
PA460002438Medicare PIN
PA802085OtherUNITEDHEALTHCARE
PA432567Medicare PIN