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General NPI Number Information
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NPI Number | 1558457150
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Entity Type | Individual
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Provider Name | STEPHANIE A SHUMATE D.O.
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1740 NICHOLASVILLE ROAD
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City | LEXINGTON
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State | KY
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Zip | 40503
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Country | US
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Telephone | 859-260-2198
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Fax |
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Provider Business Mailing Address
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Address Line | 3320 TATES CREEK ROAD SUITE 204
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City | LEXINGTON
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State | KY
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Zip | 40502
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Country | US
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Telephone | 859-268-1030
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Fax | 859-269-4120
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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 | 02329
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License Number State | KY
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