Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35-125664 | OH |
N | 2080P0202X | Pediatric Cardiologist | 35.125664 | OH |
Y | 2080P0203X | Pediatric Critical Care Doctor | 35-125664 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 35-125664 | OH |
NPI | 1316234677 |
---|---|
Provider Name | Dr. Brittany Lee Shutes |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2011 |
Last Update Date | 11/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0205262 | (05) | OH |