MEDICARE: DR. JUSTIN SHEARMAN OD

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	152W00000X	Optometrist	OEG003404	PA

General Provider Information

NPI Number	:	1306330022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN SHEARMAN OD

Provider Business Mailing Address
First Line	:	130 FOUST DR
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15904-4009
Country	:	US
Telephone Number	:	814-341-2697
Fax Number	:

Provider Business Practice Location Address
First Line	:	182 FALON LN
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-6541
Country	:	US
Telephone Number	:	814-201-5407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2018
Last Update Date	:	04/03/2019

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