Healthcare Provider Details

I. General information

NPI: 1548062169
Provider Name (Legal Business Name): EDWIN JEFFREY SHUMAKER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E CHEVES ST
FLORENCE SC
29506-2617
US

IV. Provider business mailing address

555 E CHEVES ST
FLORENCE SC
29506-2617
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-2800
  • Fax:
Mailing address:
  • Phone: 843-777-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMDO.94541
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMDO.94541LL
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: