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General NPI Number Information
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NPI Number | 1518944388
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Entity Type | Individual
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Provider Name | STEVEN MARK SHOUM MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 345 E SHORE DR
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City | MASSAPEQUA
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State | NY
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Zip | 11758-8406
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Country | US
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Telephone | 516-524-2066
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Fax |
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Provider Business Mailing Address
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Address Line | 345 E SHORE DR
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City | MASSAPEQUA
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State | NY
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Zip | 11758-8406
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Country | US
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Telephone | 516-524-2066
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 138929
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 1389292
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License Number State | NY
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