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General NPI Number Information
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NPI Number | 1770228827
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Entity Type | Individual
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Provider Name | MATTHEW JACOB SHOEMAKER DO
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Gender | Male
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 1389 GALLERIA DR STE 100
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City | HENDERSON
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State | NV
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Zip | 89014-6686
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Country | US
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Telephone | 725-333-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 1389 GALLERIA DR STE 100
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City | HENDERSON
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State | NV
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Zip | 89014-6686
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Country | US
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Telephone | 725-333-8400
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO3998
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License Number State | NV
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