Individual
LAWRENCE RAYMOND SHOEMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 IRVING AVE, SYRACUSE, NY 13210-1603
(315) 464-6340
(315) 464-6329
Mailing address
725 IRVING AVE, SYRACUSE, NY 13210-1603
(315) 464-6340
(315) 464-6329
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35271
KY
2080P0210X
Pediatric Nephrology Physician
Primary
264373
NY
2080P0210X
Pediatric Nephrology Physician
35271
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012296800
—
FL
05
—
03427103
—
NY
05
—
200111660
—
IN
05
—
64252711
—
KY
Enumeration date
11/29/2005
Last updated
09/02/2014
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