Individual
IRA DAVID SHOCKET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 IRVING ST NW, STE 205, WASHINGTON, DC 20010-2927
(202) 829-0170
(202) 829-2927
Mailing address
PO BOX 37229, BALTIMORE, MD 21297
(240) 485-5210
(301) 625-6906
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
D0043028
MD
207RG0100X
Gastroenterology Physician
Primary
MD19539
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021403600
—
DC
01
—
100005118
MEDICARE RAILROAD
DC
05
—
598291001
—
MD
Enumeration date
08/13/2006
Last updated
10/31/2012
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