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General NPI Number Information
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NPI Number | 1043407299
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Entity Type | Organization
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Legal Business Name | STEVEN M SHIMOURA MD PA
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 18111 PRINCE PHILIP DR SUITE 123
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City | OLNEY
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State | MD
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Zip | 20832-1513
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Country | US
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Telephone | 301-570-1333
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Fax | 301-570-5640
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Provider Business Mailing Address
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Address Line | 18111 PRINCE PHILIP DR SUITE 123
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City | OLNEY
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State | MD
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Zip | 20832-1513
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Country | US
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Telephone | 301-570-1333
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Fax | 301-570-5640
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN MARK SHIMOURA
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Credential | M.D.
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Telephone | 301-570-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | D0039071
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License Number State | MD
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