Individual
DR. MICHAEL DAVID SHOEMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 COMMUNITY, CLINTON, MO 64735
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2002014469
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209059716
—
MO
01
—
33846021
BCBS SERVICING PROVIDER#
MO
01
—
51411
HC USA PROVIDER I.D.
MO
Enumeration date
10/12/2005
Last updated
03/25/2019
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