Healthcare Provider Details

I. General information

NPI: 1124044326
Provider Name (Legal Business Name): MARSHALL D SHOEMAKER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 HOSPITAL DRIVE SUITE 304
FAIRHOPE AL
36532
US

IV. Provider business mailing address

188 HOSPITAL DRIVE SUITE 304
FAIRHOPE AL
36532
US

V. Phone/Fax

Practice location:
  • Phone: 251-990-1950
  • Fax: 251-990-1951
Mailing address:
  • Phone: 251-990-1950
  • Fax: 251-990-1951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARSHALL DEAN SHOEMAKER
Title or Position: OWNER PHYSICIAN
Credential: MD
Phone: 251-990-1950