Healthcare Provider Details

I. General information

NPI: 1871907584
Provider Name (Legal Business Name): DAVID G. SCHUTTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2014
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7714 CONNER RD STE 103
POWELL TN
37849-3559
US

IV. Provider business mailing address

PO BOX 52948
KNOXVILLE TN
37950-2948
US

V. Phone/Fax

Practice location:
  • Phone: 865-938-8121
  • Fax: 865-212-5561
Mailing address:
  • Phone: 865-306-5700
  • Fax: 865-584-7760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD61440
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: