Healthcare Provider Details

I. General information

NPI: 1811988272
Provider Name (Legal Business Name): BARBARA SHUTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 06/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5009 ZEIGLERS CHURCH RD
SPRING GROVE PA
17362-7574
US

IV. Provider business mailing address

5009 ZEIGLERS CHURCH RD
SPRING GROVE PA
17362-7574
US

V. Phone/Fax

Practice location:
  • Phone: 717-225-0493
  • Fax:
Mailing address:
  • Phone: 717-225-0493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD032337E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: