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General NPI Number Information
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NPI Number | 1083698112
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Entity Type | Individual
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Provider Name | JOHN V SHUFFLEBARGER M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 123 SUMMER ST STE 370N
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City | WORCESTER
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State | MA
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Zip | 01608-1216
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Country | US
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Telephone | 508-964-5580
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Fax | 508-368-3957
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Provider Business Mailing Address
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Address Line | 123 SUMMER ST STE 370N
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City | WORCESTER
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State | MA
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Zip | 01608-1216
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Country | US
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Telephone | 508-964-5580
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Fax | 508-368-3957
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 79920
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 79920
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License Number State | MA
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