Healthcare Provider Details

I. General information

NPI: 1003420456
Provider Name (Legal Business Name): ROBIN SHUMAKER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SPRING HILL AVE
MOBILE AL
36607-2303
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-300-2240
  • Fax: 251-300-2249
Mailing address:
  • Phone: 866-401-3057
  • Fax: 318-868-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.1671
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: