MEDICARE: DR. KEVIN BARRY SHUTE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	46222	TN
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	2008-01060	NC
3	207L00000X	Anesthesiology Physician	2008-01060	NC

General Provider Information

NPI Number	:	1770763724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN BARRY SHUTE M.D.

Provider Business Mailing Address
First Line	:	207 OLD LEXINGTON RD
Second Line	:
City	:	THOMASVILLE
State	:	NC
Zip	:	27360-3428
Country	:	US
Telephone Number	:	336-422-6615
Fax Number	:	336-360-9135

Provider Business Practice Location Address
First Line	:	211 OLD LEXINGTON RD
Second Line	:
City	:	THOMASVILLE
State	:	NC
Zip	:	27360-3428
Country	:	US
Telephone Number	:	336-422-6615
Fax Number	:	336-360-9135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	01/15/2026

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