Basic Information
| Provider Information | |||||||||
| NPI: | 1003806175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHUMAKER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 PARKINGWAY | ||||||||
| Address2: | P.O. BOX 146 | ||||||||
| City: | COHASSET | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020251708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819748988 | ||||||||
| FaxNumber: | 7813831239 | ||||||||
| Practice Location | |||||||||
| Address1: | 12 PARKINGWAY | ||||||||
| Address2: | |||||||||
| City: | COHASSET | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020251708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819748988 | ||||||||
| FaxNumber: | 7813831239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 8172 | MA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.