Healthcare Provider Details

I. General information

NPI: 1700279171
Provider Name (Legal Business Name): SHAWN CUEVAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2015
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 W CENTRAL AVE
DELAWARE OH
43015-1410
US

IV. Provider business mailing address

561 W CENTRAL AVE
DELAWARE OH
43015-1410
US

V. Phone/Fax

Practice location:
  • Phone: 740-615-1000
  • Fax:
Mailing address:
  • Phone: 740-615-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34.013888
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: