MEDICARE: DR. BRIAN DAVID SHUMAN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1685	NH

General Provider Information

NPI Number	:	1760444251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN DAVID SHUMAN DMD

Provider Business Mailing Address
First Line	:	30 INDIAN RIDGE RD
Second Line	:
City	:	EAST HAMPSTEAD
State	:	NH
Zip	:	03826-2471
Country	:	US
Telephone Number	:	603-382-4751
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CHASE ST
Second Line	:
City	:	KINGSTON
State	:	NH
Zip	:	03848-3005
Country	:	US
Telephone Number	:	603-642-3276
Fax Number	:	603-642-5733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	07/08/2007

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