Shutak, Michael

Shutak, Michael is an individual health care provider with primary practice located at 2601 N Herritage St , Kinston NC 28501-1502. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Shutak, Michael can be contacted via phone (252) 208-7800.

Contact Information

Primary practice address
2601 N Herritage St Kinston NC 28501-1502
Phone: (252) 208-7800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 101798 North Carolina

Profile Details

NPI number 1366557472
LBN Legal business name Shutak, Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2006
Last updated Jan 14th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366557472 NPPES
Other 12410017 CAQH

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