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General NPI Number Information
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NPI Number | 1053060509
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Entity Type | Individual
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Provider Name | JACOB WESLEY SHULMISTER DPM
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Gender | Male
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 950 E HARVARD AVE STE 300
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City | DENVER
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State | CO
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Zip | 80210-7005
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Country | US
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Telephone | 303-722-6864
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Fax | 303-722-5113
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Provider Business Mailing Address
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Address Line | 950 E HARVARD AVE STE 300
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City | DENVER
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State | CO
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Zip | 80210-7005
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Country | US
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Telephone | 303-722-6864
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Fax | 303-722-5113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 0000967
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0000967
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License Number State | CO
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