Healthcare Provider Details

I. General information

NPI: 1124245865
Provider Name (Legal Business Name): JANELLE ADENIKA SHUMATE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 GRANVILLE CORS STE 400
OXFORD NC
27565-4009
US

IV. Provider business mailing address

6409 FAYETTEVILLE RD STE 120-323
DURHAM NC
27713-6297
US

V. Phone/Fax

Practice location:
  • Phone: 984-307-4787
  • Fax:
Mailing address:
  • Phone: 984-307-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200901229
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: