Provider Demographics
NPI:1982077202
Name:SHUMATE, MICHAEL ALBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALBERT
Last Name:SHUMATE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10270 JUNIPER CT
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-2608
Mailing Address - Country:US
Mailing Address - Phone:440-724-7134
Mailing Address - Fax:
Practice Address - Street 1:10270 JUNIPER CT
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-2608
Practice Address - Country:US
Practice Address - Phone:440-724-7134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03112280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist