Individual
DR. DIANE IRAGENA SHUMBUSHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1575 WASHINGTON ST, WATERTOWN, NY 13601-9371
(315) 785-4155
(315) 779-5066
Mailing address
1575 WASHINGTON ST, WATERTOWN, NY 13601-9371
(315) 785-4155
(315) 779-5066
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101264178
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
328335
NY
Other
Enumeration date
05/16/2016
Last updated
04/17/2024
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