Basic Information
| Provider Information | |||||||||
| NPI: | 1508123779 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHUMAKER | ||||||||
| FirstName: | SHANNA | ||||||||
| MiddleName: | VIRGINIA NANCY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 910 ADAMS ST SE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358013730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565337420 | ||||||||
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| Practice Location | |||||||||
| Address1: | 910 ADAMS ST SE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358013730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565337420 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2012 | ||||||||
| LastUpdateDate: | 07/05/2016 | ||||||||
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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 | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | 35103 | AL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.