Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 25923 | NE |
N | 207X00000X | Orthopaedic Surgeon | 94-06441 | KS |
N | 207X00000X | Orthopaedic Surgeon | M10971 | ID |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 25923 | NE |
NPI | 1780735340 |
---|---|
Provider Name | Dr. Shane A. Schutt |
First Address | Omaha, NE 68114-3426 |
Second Address | Omaha, NE 68118-2049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1780735340 | (05) | IA |
47068731742 | (05) | NE |
47068731751 | (05) | NE |