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Individual

DR. JONATHAN KALE GAVIN SHUMATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1010 SW COAST HWY STE 102, NEWPORT, OR 97365-5239
(541) 265-4253
(541) 265-4035
Mailing address
1010 SW COAST HWY STE 102, NEWPORT, OR 97365-5239
(541) 265-4253
(541) 265-4035

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD.200122
LA
207V00000X
Obstetrics & Gynecology Physician
MD00047503
WA
207V00000X
Obstetrics & Gynecology Physician
Primary
MD154161
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500635045
OR
Enumeration date
07/28/2005
Last updated
10/29/2020
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