Basic Information
| Provider Information | |||||||||
| NPI: | 1912932658 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHOEMAKER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | W. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 108 EASY ST | ||||||||
| Address2: | |||||||||
| City: | PROSSER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993509565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5095409258 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 S 11TH ST | ||||||||
| Address2: | |||||||||
| City: | SUNNYSIDE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989442240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098377722 | ||||||||
| FaxNumber: | 5098372587 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 05/01/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | MD 00029733 | WA | Y | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085R0202X | ME110175 | FL | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.