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General NPI Number Information
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NPI Number | 1912932658
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Entity Type | Individual
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Provider Name | DAVID W. SHOEMAKER JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 500 S 11TH ST
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City | SUNNYSIDE
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State | WA
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Zip | 98944-2240
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Country | US
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Telephone | 509-837-7722
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Fax | 509-837-2587
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Provider Business Mailing Address
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Address Line | PO BOX 719
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City | SUNNYSIDE
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State | WA
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Zip | 98944-0719
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Country | US
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Telephone | 509-837-1617
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME110175
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MD 00029733
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License Number State | WA
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