Healthcare Provider Details

I. General information

NPI: 1609004936
Provider Name (Legal Business Name): SHAUNA LEIGH GUTHRIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HUNT DR
OXFORD NC
27565-3497
US

IV. Provider business mailing address

1103 CLOSS CT
HENDERSON NC
27536-3570
US

V. Phone/Fax

Practice location:
  • Phone: 919-693-2141
  • Fax: 919-693-8517
Mailing address:
  • Phone: 252-572-1731
  • Fax: 877-992-2298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2013-01090
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number2013-01090
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: