Individual
DR. JONATHAN SHUMWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
555 W SR 164, SALEM, UT 84653
(801) 465-4896
(801) 465-3267
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12244727-1204
UT
Other
Enumeration date
03/19/2018
Last updated
06/29/2021
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