Basic Information
| Provider Information | |||||||||
| NPI: | 1124245865 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHUMATE | ||||||||
| FirstName: | JANELLE | ||||||||
| MiddleName: | ADENIKA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 OBERLIN RD | ||||||||
| Address2: | STE 204 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276051397 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198280035 | ||||||||
| FaxNumber: | 9198280355 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 OBERLIN RD | ||||||||
| Address2: | STE 204 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276051397 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198280035 | ||||||||
| FaxNumber: | 9198280355 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2007 | ||||||||
| LastUpdateDate: | 12/14/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 200901229 | NC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.