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Individual
GARRY CARLTON SHOEMAKER
Active
Individual
GARRY CARLTON SHOEMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618000704
VA
152WC0802X
Corneal and Contact Management Optometrist
Primary
0618000704
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009233849
—
VA
01
—
394271
ANTHEM BC/ BS
VA
01
—
410039168
RAILROAD MEDICARE
VA
01
—
5464802
AETNA
VA
Enumeration date
07/07/2006
Last updated
02/12/2024
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