Healthcare Provider Details

I. General information

NPI: 1649207762
Provider Name (Legal Business Name): RICHARD C SHUMWAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 WOODLAND ST RADIATION ONCOLOGY
HARTFORD CT
06105-1217
US

IV. Provider business mailing address

94 WOODLAND STREET DEPT OF RADIATION ONCOLOGY
HARTFORD CT
06105
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-4568
  • Fax: 860-714-8019
Mailing address:
  • Phone: 860-714-4568
  • Fax: 860-714-8019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number031465
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: