Healthcare Provider Details

I. General information

NPI: 1902368822
Provider Name (Legal Business Name): MEGAN CIBULAS SHUMWAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19566 E COUNTRY CLUB DR
AVENTURA FL
33180-4830
US

IV. Provider business mailing address

19566 E COUNTRY CLUB DR
AVENTURA FL
33180-4830
US

V. Phone/Fax

Practice location:
  • Phone: 248-376-3501
  • Fax:
Mailing address:
  • Phone: 248-376-3501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberV7650
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberME181736
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberV7650
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberME181736
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: