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Individual

MAYNARD A. SHUMWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
110 LOMOND CT, UTICA, NY 13502-5950
(315) 292-1264
(315) 266-0385
Mailing address
601 GATES RD, STE 3, VESTAL, NY 13850
(607) 584-7385
(607) 772-1223

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001412
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03324334
NY
Enumeration date
07/10/2006
Last updated
07/23/2014
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