MEDICARE: DREW SHULMAN, DMD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1184000838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREW SHULMAN, DMD, PC

Provider Business Mailing Address
First Line	:	2417 WELSH RD
Second Line	:	STE 10
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-2213
Country	:	US
Telephone Number	:	215-969-8080
Fax Number	:	215-969-2321

Provider Business Practice Location Address
First Line	:	2417 WELSH RD
Second Line	:	STE 10
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-2213
Country	:	US
Telephone Number	:	215-969-8080
Fax Number	:	215-969-2321

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DREW SHULMAN
Credential	:	DMD
Telephone Number	:	215-969-8080

Provider Enumeration Date	:	08/05/2015
Last Update Date	:	04/26/2016

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