Individual
DR. JAMES LEE SHOEMAKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 523-3160
Mailing address
PO BOX 1241, SOUTH BEND, IN 46624-1241
(885) 691-9888
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01062988A
IN
207P00000X
Emergency Medicine Physician
4301083448
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000504277
ANTHEM
IN
05
—
200851620
—
IN
01
—
P00411868
RAIL ROAD MEDICARE
IN
Enumeration date
10/19/2006
Last updated
04/05/2016
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