| Wendy A Shumate Md | |
|
105 Durian St Suite A Vista CA 92083-6205 | |
| (760) 630-4715 | |
| (760) 630-4249 |
| Full Name | Wendy A Shumate Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 105 Durian St, Vista, California |
| Authorized Official Name and Position | Wendy A. Shumate (OWNER) |
| Authorized Official Contact | 7606304715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wendy A Shumate Md 105 Durian St Suite A Vista CA 92083-6205 Ph: (760) 630-4715 | Wendy A Shumate Md 105 Durian St Suite A Vista CA 92083-6205 Ph: (760) 630-4715 |
| NPI Number | 1801089784 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 05/27/2010 |
| Medicare PECOS PAC ID | 3375518749 |
|---|---|
| Medicare Enrollment ID | O20040830000333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801089784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Wendy Ann Shumate |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669457313 PECOS PAC ID: 9537357173 Enrollment ID: I20101222000891 |
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