Provider Demographics
NPI:1851313399
Name:SHOEMAKER, DREW D (MD)
Entity type:Individual
Prefix:MR
First Name:DREW
Middle Name:D
Last Name:SHOEMAKER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 844715
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-4715
Mailing Address - Country:US
Mailing Address - Phone:417-761-5214
Mailing Address - Fax:417-761-5065
Practice Address - Street 1:800 S PARK AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-4855
Practice Address - Country:US
Practice Address - Phone:417-893-7700
Practice Address - Fax:660-882-6093
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1081252083A0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO105794OtherBCBS OF MO #
MO203784202Medicaid
MO80130974Medicare ID - Type UnspecifiedRR MEDICARE #
MO203784202Medicaid
MOG43839Medicare UPIN