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NPI Code Detail

MEDICARE: JOHN MICHAEL SHIMKO D.P.M.

MEDICARE: JOHN MICHAEL SHIMKO D.P.M.
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
1213E00000XPodiatrist270NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10816HOTHERNCBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194718619
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MICHAEL SHIMKO D.P.M.
Provider Business Mailing Address
First Line : 10130 PERIMETER PKWY STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-0197
Country : US
Telephone Number : 888-849-7379
Fax Number : 855-857-7333
Provider Business Practice Location Address
First Line : 10130 PERIMETER PKWY STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-0197
Country : US
Telephone Number : 888-849-7379
Fax Number : 855-857-7333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 10/12/2017

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