Individual
GARRY CARLTON SHOEMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1608 PLEASURE HOUSE RD, SUITE 106, VIRGINIA BEACH, VA 23455-4046
(757) 460-9402
(757) 460-9462
Mailing address
1608 PLEASURE HOUSE RD, SUITE 106, VIRGINIA BEACH, VA 23455-4046
(757) 460-9402
(757) 460-9462
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618000704
VA
152WC0802X
Corneal and Contact Management Optometrist
Primary
0618000704
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009233849
—
VA
01
—
394271
ANTHEM BC/ BS
VA
01
—
410039168
RAILROAD MEDICARE
VA
01
—
5464802
AETNA
VA
Enumeration date
07/07/2006
Last updated
02/12/2024
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