Provider Demographics
NPI:1194754739
Name:SHEMO, JOHN PALMER DAVID (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PALMER DAVID
Last Name:SHEMO
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2496 OLD IVY ROAD
Mailing Address - Street 2:SUITE 400 PSYCHIATRIC ALLIANCE OF THE BLUE RIDGE
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4895
Mailing Address - Country:US
Mailing Address - Phone:434-984-6777
Mailing Address - Fax:434-296-1412
Practice Address - Street 1:2496 OLD IVY ROAD
Practice Address - Street 2:SUITE 400 PSYCHIATRIC ALLIANCE OF THE BLUE RIDGE
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4895
Practice Address - Country:US
Practice Address - Phone:434-984-6777
Practice Address - Fax:434-296-1412
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010310152084P0800X, 2084P0802X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA054767OtherANTHEM
C35164Medicare UPIN