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General NPI Number Information
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NPI Number | 1275978017
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Entity Type | Individual
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Provider Name | REBECCA RYAN SHOEMAKER MD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 732 THIMBLE SHOALS BLVD STE 803
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City | NEWPORT NEWS
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State | VA
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Zip | 23606
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Country | US
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Telephone | 757-933-8888
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Fax | 757-806-6320
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Provider Business Mailing Address
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Address Line | 1250 E MARSHALL ST
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City | RICHMOND
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State | VA
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Zip | 23298-5051
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Country | US
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Telephone |
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Fax |
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 00116028976
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 0101263940
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License Number State | VA
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