Individual
DR. EUGENE A. SHOOTER, JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5276 DAWES AVE, ALEXANDRIA, VA 22311-1404
(703) 379-7350
(703) 379-7352
Mailing address
5276 DAWES AVE, ALEXANDRIA, VA 22311-1404
(703) 379-7350
(703) 379-7352
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00810002612
VA
103TC0700X
Clinical Psychologist
PSY1878
DC
103TC0700X
Clinical Psychologist
PSY518
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110936
PCI APS
VA
01
—
142975
T-MED BC/BS VA
VA
01
—
158367
PCI TRICARE
VA
01
—
2122539
MAMSI
VA
01
—
228758
PCI KAISER PERMANENTE
VA
01
—
2787110
PCI AETNA
VA
01
—
453769
PCI ANTHEM
VA
01
—
48900016
CAREFIRST BC/BS
VA
01
—
9123953
PHCS
VA
01
—
G3960017
BCBS DC
DC
Enumeration date
06/20/2006
Last updated
03/06/2008
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