Individual
DR. JONATHAN O SHOOPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-5820
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01065118A
IN
207L00000X
Anesthesiology Physician
57361
WI
207L00000X
Anesthesiology Physician
MD60071468
WA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
01065118A
IN
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
57361
WI
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
84892
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477712677
—
WI
Enumeration date
06/03/2008
Last updated
09/01/2022
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