Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wyatt Boothby-Shoemaker, MD

Individual provider Dermatology Physician · NPI 1326781220

Wyatt Boothby-Shoemaker, MD is a Dermatology in Owosso, Michigan. Qualified in 2022, 4 years ago. Practices as a sole proprietor. Licensed in Michigan.

Years since qualifying
4
Licensed in
MI
In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

200 Health Park Dr Ste 205
Owosso, MI 48867-1291
Phone: (989) 723-8666
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 1326781220 (MI)

Record details

NPI number1326781220
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 18, 2022
Last updated in NPPESJuly 9, 2026
Certification dateJuly 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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