Healthcare Provider Details

I. General information

NPI: 1053554261
Provider Name (Legal Business Name): ERIC MICHAEL SHOEMAKER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 S BROADWAY STE 310
LITTLETON CO
80122-2624
US

IV. Provider business mailing address

1805 SHEA CENTER DR STE 450
HIGHLANDS RANCH CO
80129-2255
US

V. Phone/Fax

Practice location:
  • Phone: 303-584-5844
  • Fax: 303-256-9717
Mailing address:
  • Phone: 303-357-2559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS13075
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number49156
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: