Provider Demographics
NPI:1427080324
Name:SHULMISTER, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SHULMISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 GREENBRIER CIR STE H
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2643
Mailing Address - Country:US
Mailing Address - Phone:757-366-3100
Mailing Address - Fax:757-366-9474
Practice Address - Street 1:1100 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2403
Practice Address - Country:US
Practice Address - Phone:757-366-3100
Practice Address - Fax:757-366-9474
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101037936207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6081380Medicaid
B10231Medicare UPIN
110001855Medicare PIN