Provider Demographics
NPI:1174591234
Name:SHUMAKER, JOAN MARIE (DPM)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:MARIE
Last Name:SHUMAKER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5700 OLD RICHMOND AVE
Mailing Address - Street 2:E24
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226
Mailing Address - Country:US
Mailing Address - Phone:804-282-6576
Mailing Address - Fax:804-282-5223
Practice Address - Street 1:5700 OLD RICHMOND AVE
Practice Address - Street 2:E24
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226
Practice Address - Country:US
Practice Address - Phone:804-282-6576
Practice Address - Fax:804-282-5223
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000965213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA272341OtherMAMSI
VA230872OtherANTHEM BC BS
VA9302450Medicaid
VA230851OtherANTHEM BC BS
VA272341OtherMAMSI
VA230851OtherANTHEM BC BS
VA9302450Medicaid
VA480000520Medicare PIN