Provider Demographics
NPI:1487802823
Name:SHIMAN, MARC
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:SHIMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6056 BOYNTON BEACH BLVD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3584
Mailing Address - Country:US
Mailing Address - Phone:561-737-9227
Mailing Address - Fax:
Practice Address - Street 1:6056 BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE 145
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3584
Practice Address - Country:US
Practice Address - Phone:561-737-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUNKNOWN207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine