Basic Information
| Provider Information | |||||||||
| NPI: | 1770699050 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHUMAN | ||||||||
| FirstName: | TOBI | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 BROOKS LANE | ||||||||
| Address2: | SUITE 180 | ||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124693600 | ||||||||
| FaxNumber: | 4124693630 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 BROOKS LANE | ||||||||
| Address2: | SUITE 180 | ||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124693600 | ||||||||
| FaxNumber: | 4124693630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2006 | ||||||||
| LastUpdateDate: | 04/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 014478 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 014478 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 1021828180001 | 05 | PA | MEDICAID |