Dr. John Michael Shutack
Neurosurgeon
300 Medical Pkwy Ste 206
Chesapeake
, Virginia 23320
Dr. John Michael Shutack
Neurosurgeon
300 Medical Pkwy Ste 206
Chesapeake
, Virginia 23320
(757) 277-9939
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About
Features
Specialties
- Neurosurgeon
Languages spoken
- English
Location
First Address
- Dr. John Michael Shutack
- 667 Kingsborough Sq Ste 101
- Chesapeake, VA
- Zip : 23320-4999
- Fax : (757) 277-9939
- Phone : (757) 690-8990
Second Address
- Dr. John Michael Shutack
- 300 Medical Pkwy Ste 206
- Chesapeake, VA
- Zip : 23320
- Fax : (757) 277-9939
- Phone : (757) 690-8990
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207T00000X | Neurosurgeon | 0101102740 | VA |
National Provider Identifier
| NPI | 1104927458 |
|---|---|
| Provider Name | Dr. John Michael Shutack |
| First Address | Chesapeake, VA 23320-4999 |
| Second Address | Chesapeake, VA 23320 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/09/2006 |
| Last Update Date | 07/05/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0101102740 | MEDICAL LICENSE (01) | VA |
| 202I148725 | (02) | GA |
| H61012 | (02) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.